New Jersey Assembly Bill A416

New Jersey 2024-2025 Regular Session

• Introduced: 1/9/24
• Refer: 1/9/24

Caption

Establishes minimum Medicaid reimbursement rate for pediatric special care nursing facilities; makes an appropriation.

Impact

The introduction of this bill is significant for pediatric SCNFs, as it seeks to close a notable reimbursement gap that currently exists. Presently, there is approximately a 63.5% discrepancy in reimbursement rates among the four facilities in operation in New Jersey that cater to this demographic. By ensuring a minimum reimbursement rate, the bill aims to promote equity in funding across facilities, enhancing their ability to provide necessary care and potentially improving health outcomes for vulnerable children.

Summary

Bill A416 aims to establish a minimum Medicaid reimbursement rate for pediatric special care nursing facilities (SCNFs) in New Jersey. The bill specifies that the Division of Medical Assistance and Health Services will reimburse facilities participating in the Medicaid program at a base rate of no less than $950 per day. This rate will apply only to facilities that comply with state and federal regulations regarding licensure, safety, and quality of care. The intent is to ensure that these specialized facilities can adequately care for medically fragile children and youth up to the age of 21.

Contention

While the bill has garnered support for addressing funding inequalities, it may face scrutiny regarding the appropriations involved and the potential impact on the state's budget. Concerns may arise over whether the specified reimbursement level is sustainable in light of broader fiscal constraints. Additionally, there could be discussions on how effectively the bill will ensure that quality of care improves alongside increased funding, particularly regarding how funds will be allocated and monitored to achieve the desired outcomes for facilities and the children they serve.