New Jersey Senate Bill S669

New Jersey 2024-2025 Regular Session

• Introduced: 1/9/24
• Refer: 1/9/24

Caption

Extends COVID-19 Medicaid per diem rate, and requires Medicaid coverage without prior authorization, for certain partial care behavioral health and substance use disorder treatment services.

Impact

By extending these financial provisions, SB 669 aims to enhance access to critical mental health services without the burden of prior authorization requirements. This shift is anticipated to reduce administrative hurdles for healthcare providers, thus improving the overall efficiency of service delivery. The bill mandates that providers will not need prior authorization for up to five hours of coverage per day, enabling flexibility in how care is delivered while focusing on the individual needs of patients. This aligns with the ongoing need for accessible and timely behavioral healthcare.

Summary

Senate Bill 669 proposes significant amendments to Medicaid reimbursement policies for partial care services related to behavioral health and substance use treatment. Specifically, the bill extends the per diem rate for partial care services provided via telehealth for an additional 180 days following the end of the federal Medicaid waiver that initially authorized these rates. This extension is crucial for the financial stability of service providers as they transition back to in-person care in the wake of the COVID-19 pandemic. The per diem rates allow for sustainable support of patients and facilitate necessary adaptations in service delivery.

Contention

Challenges may arise around the implementation of this bill, particularly concerning the adequacy of reimbursement levels and the experience of providers adapting to new compliance measures. Some stakeholders might express concerns about whether the extensions and removed restrictions truly address the gaps in service availability that have become evident during the pandemic. It will be crucial for the Division of Medical Assistance and Health Services to evaluate the effectiveness of these provisions based on the submitted status reports from providers to ensure that they meet ongoing patient care needs effectively.