New Jersey Senate Bill S3767

New Jersey 2022-2023 Regular Session

• Introduced: 5/8/23
• Refer: 5/8/23

Caption

Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.

Impact

The implementation of this bill would represent a significant improvement in the accessibility and quality of care for individuals with brain injuries who rely on these structured programs for their rehabilitation and everyday support. By aligning reimbursement rates with those for developmental disabilities, it is believed that this will enhance the quality of services available and increase the willingness of service providers to offer such programs. Additionally, this move could potentially lead to better health outcomes for those affected by brain injuries.

Summary

Bill S3767 aims to establish minimum Medicaid reimbursement rates specifically for structured day program services aimed at individuals requiring treatment for brain injuries. This amendment to the previously existing law will now ensure that structured day services are reimbursed at a level commensurate with existing services for developmental disabilities, addressing a significant gap in funding for such critical therapies. It aims to elevate the reimbursement rate for structured day program services from the current $3.65 for every 15 minutes of service to $9.09, aligning it with the average paid for higher-tier day habilitation services.

Contention

Notably, there may be concerns regarding the potential strain on the state's Medicaid budget and the implications for overall state spending on healthcare. Some stakeholders could argue about the sustainability of increased reimbursement rates, particularly if additional funding is not allocated for these services. Furthermore, discussions may revolve around the differentiating criteria of 'brain injury service providers' and the requirement for licenses, which could impact the availability of services in certain regions.