ASSEMBLY APPROPRIATIONS COMMITTEE

STATEMENT TO

[Second Reprint]

ASSEMBLY, No. 4914

with committee amendments

STATE OF NEW JERSEY

DATED:  JUNE 22, 2023

      The Assembly Appropriations Committee reports favorably and with committee amendments Assembly Bill No. 4914 (2R).

      As amended by the committee, this bill establishes the "Hospital at Home Act."

      Under the bill as amended, the Department of Health (department) is to establish a State program to permit a hospital to provide acute care services to an individual outside of the hospital’s licensed facility and within a private residence designated by the individual.  The State program is to be established in a manner that is consistent with the provisions of the federal Acute Hospital Care at Home Program (federal program), as authorized by the federal Centers for Medicare and Medicaid Services, or any successor federal program.  Any hospital issued a waiver to operate, or otherwise approved to participate in, the federal Acute Hospital Care at Home Program will be permitted to operate or to continue to operate the federal program in the same manner as permitted under federal law, and is to be integrated into the State program established pursuant to the bill. 

      Under the bill as amended, the NJ FamilyCare and Medicaid programs, and any carrier that offers a health benefits plan in this State, is to provide coverage for acute hospital care services delivered by a credentialed health care provider to a covered person under the State Acute Hospital Care at Home Program established under the bill, on the same basis as when services are delivered within the facilities of a hospital.  Reimbursement payments are to be 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.  Carriers are not to utilize more stringent utilization management criteria than apply when those services are provided within the facilities of a hospital.

COMMITTEE AMENDMENTS:

      The committee amendments add a definition for the federal Acute Hospital Care at Home Program, which definition clarifies that the term applies to the program previously established by the federal Centers for Medicare and Medicaid Services (CMS) or any successor program established by Congress or the CMS.

      The committee amendments provide that the program established under the bill will run concurrent with, and will terminate upon the expiration of, the federal Acute Hospital Care at Home Program.

      The committee amendments provide that a hospital that is issued a waiver to participate in the federal program will be authorized to continue participating in the federal program and will be integrated into the State program established under the bill.  As introduced, this provision only applied to hospitals that received a waiver for the federal program prior to the effective date of the bill.

      The committee amendments make various technical changes to clarify internal references to the State and federal hospital at home programs.

FISCAL IMPACT:

      This bill has not been certified as requiring a fiscal note.