A4914 5R

Sponsored by:

Assemblyman HERB CONAWAY, JR.

District 7 (Burlington)

Assemblyman STERLEY S. STANLEY

District 18 (Middlesex)

Assemblywoman ANGELA V. MCKNIGHT

District 31 (Hudson)

Senator JOSEPH F. VITALE

District 19 (Middlesex)

Senator TROY SINGLETON

District 7 (Burlington)

Co-Sponsored by:

Assemblywomen Jimenez, Murphy, Speight, Reynolds-Jackson, Assemblyman Freiman, Assemblywomen Lampitt, Jasey, Assemblyman Wimberly, Assemblywoman Swain, Assemblyman Tully, Assemblywoman Lopez, Senators Singer, Diegnan, Durr and O'Scanlon

SYNOPSIS

Establishes "Hospital at Home Act."

CURRENT VERSION OF TEXT

As amended by the Senate on June 30, 2023.

An Act concerning acute hospital care and supplementing Title 26 of the Revised Statutes.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. This act shall be known and may be cited as the "Hospital at Home Act."

2. As used in this act:

“Carrier,” “covered person,” and “health benefits plan,” shall have the same meaning as provided for those terms under section 2 of P.L.1997, c.192 (C.26:2S-2).

“Department” means the Department of Health.

³“Federal acute Hospital Care at Home Program” or “federal program” means the program established by the federal Centers for Medicare and Medicaid Services under 42 U.S.C. Section 1320b-5 and extended by 42 U.S.C 1395cc-7, or any successor program established by an act of Congress or the federal Centers for Medicare and Medicaid Services.³

“Hospital” means ¹[a general] an¹ acute care hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).

³[“Program”] “State program”³ means the hospital at home program established by the department pursuant to section 3 of this act.

3. a. Notwithstanding any provision of law to the contrary, the department shall establish a ³State³ program to permit a hospital to provide acute care services to ¹[a covered person] an individual¹ outside of the hospital’s licensed facility and within a private residence designated by the ¹[covered person] individual¹. The program shall be established in a manner that is consistent with the provisions of the ³federal³ Acute Hospital Care at Home Program ³[, as authorized by the federal Centers for Medicare and Medicaid Services] and shall remain in effect for such time as the federal Acute Hospital Care at Home Program remains in effect³ .

b. Any hospital ³[previously in receipt of] issued³ a waiver to operate, or otherwise approved to participate in ³,³ the ³[Centers for Medicare and Medicaid Services’s] federal³ Acute Hospital Care at Home Program ³[prior to the effective date of this act,]³ shall be permitted to operate ⁴[or to continue to operate]⁴ ³under³ the ³federal³ program ⁴[in the same manner as]⁴ ³[previously] ⁴[is³] to the extent⁴ permitted under ³the³ federal ³[law] program³ ⁴[, and shall be integrated into the ³State³ program established pursuant to this section] for such time as the federal program remains in effect⁴ .

4. The NJ FamilyCare and Medicaid programs, and any carrier that offers a health benefits plan in this State, shall provide coverage ¹[and payment]¹ for acute hospital care services delivered ⁴[¹by a credentialed health care provider¹]⁴ to a covered person through the program established pursuant to section 3 of this act, on the same basis as when services are delivered within the facilities of a hospital. Reimbursement payments under this section shall be ⁵established pursuant to the contract between the carrier and the hospital and shall be⁵ provided to the hospital, facility, or organization providing the services or the individual practitioner who delivered the reimbursable services, or to the agency, facility, or organization that employs or contracts with the individual practitioner who delivered the reimbursable services, as appropriate. Carriers shall not utilize more stringent utilization management criteria than apply when those services are provided within the facilities of a hospital.

⁴5. Licensed health care providers providing acute care services to a covered person outside the hospital’s licensed space and within a private residence designated by the covered person shall be credentialed by a carrier as a condition of the services being deemed to be network services.⁴

⁴[5.] 6.⁴ The Commissioner of Human Services shall apply for any State plan amendments or waivers as may be necessary to implement the provisions of this act and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.

⁴[6.] 7.⁴ The Commissioners of Health and Human Services shall jointly or separately adopt rules and regulations, in accordance with the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et seq.), if necessary to effectuate the provisions of this act. The Commissioners of Health and Human Services shall jointly or separately waive any rules or regulations if necessary to implement the provisions of this act.

⁴[7.] 8.⁴This act shall take effect ²[immediately] on the 120th day next following enactment².