New Jersey Assembly Bill A1796

New Jersey 2024-2025 Regular Session

• Introduced: 1/9/24
• Refer: 1/9/24
• Chaptered: 1/9/24
• Passed: 1/9/24

Caption

Allows licensed clinical social worker to directly bill NJ FamilyCare for covered services provided to program beneficiaries.

Impact

If the bill is enacted, it would significantly alter the landscape of healthcare service reimbursement in New Jersey. Specifically, it mandates that the Division of Medical Assistance and Health Services and managed care organizations must accept and reimburse claims from clinical social workers, provided the services are rendered to NJ FamilyCare beneficiaries, are covered under the program, and the provider meets required licensure standards. This change is intended to make mental health services more accessible to families utilizing NJ FamilyCare, potentially improving health outcomes and supporting the mental health workforce in New Jersey.

Summary

Assembly Bill A1796, introduced in the New Jersey 221st Legislature, seeks to allow licensed clinical social workers to directly bill NJ FamilyCare for covered services they provide to beneficiaries of the program. Currently, clinical social workers may face barriers in accessing appropriate reimbursement for the essential services they provide to patients under this state-operated healthcare program. The bill aims to eliminate these barriers, ensuring more straightforward and efficient reimbursement processes for these professionals and their clients.

Contention

There may be contention surrounding A1796, particularly regarding its implementation and potential financial implications for the NJ FamilyCare program. Opponents might raise concerns about the fiscal impact on the state's Medicaid budget, arguing that an increase in providers billing directly could lead to higher overall expenditures. Furthermore, there could be debates on the adequacy of qualifications for social workers who will be allowed to bill for services directly, with some advocates possibly voicing the need for stringent regulations to ensure quality care.