§§1,2
C.30:4D-6w
and 30:4D-6x
An Act concerning reimbursement under NJ FamilyCare and supplementing P.L.1968, c.413 (C.30:4D-1 et seq.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. Notwithstanding any law, rule, or regulation to the contrary, the Division of Medical Assistance and Health Services within the Department of Human Services, or a managed care organization that contracts with the division to provide medical services to beneficiaries of the NJ FamilyCare program, shall 1:
(1)1 accept and reimburse claims for services 1under the NJ FamilyCare program when1 submitted by a clinical social worker 1, a professional counselor, or a marriage and family therapist1 provided that:
1[(1)] (a)1 the services are rendered to a NJ FamilyCare beneficiary;
1[(2)] (b)1 the services rendered are covered under the NJ FamilyCare program;
1[(3)] (c)1 the 1[clinical social worker] provider1 holds a current, valid license issued pursuant to P.L.1991, c.134 (C.45:15BB-1 et seq.) 1if a clinical social worker, P.L.1993, c.340 (C.45:8B-34 et seq.) if a professional counselor, and P.L.1968, c.401 (C.45:8B-1 et seq.) if a marriage and family therapist1; and
1[(4)] (d)1 the 1[clinical social worker] provider1 is an approved provider of services under the NJ FamilyCare program1; and
(2) expand eligibility for reimbursable services under the NJ FamilyCare program to include those services provided by a social worker, an associate counselor, or an associate marriage and family therapist provided that:
(a) the services are rendered to a NJ FamilyCare beneficiary;
(b) the services rendered are covered under the NJ FamilyCare program;
(c) the provider holds a current, valid license issued pursuant to P.L.1991, c.134 (C.45:15BB-1 et seq.) if a social worker, P.L.1993, c.340 (C.45:8B-34 et seq.) if an associate counselor, and P.L.1968, c.401 (C.45:8B-1 et seq.) and P.L.2017, c.350 (C.45:8B-18.1 et al.) if an associate marriage and family therapist;
(d) the claim is submitted by a licensed clinical social worker, a licensed professional counselor, or a licensed marriage and family therapist who serves as the provider’s supervising practitioner, as approved by:
(i) the State Board of Social Work Examiners pursuant to subsection d. of section 4 of P.L.1991, c.134 (C.45:15BB-4) in the case of a social worker;
(ii) the State Board of Marriage and Family Therapy Examiners pursuant to section 17 of P.L.1993, c.340 (C.45:8B-50) in the case of an associate counselor; or
(iii) the State Board of Marriage and Family Therapy Examiners pursuant to section 10 of P.L.2017, c.350 (C.45:8B-18.2) in the case of an associate marriage and family therapist; and
(e) the provider’s supervising practitioner is an approved provider of services under the NJ FamilyCare program and serves as the rendering practitioner for the purposes of the claim1.
b. 1Nothing in this section shall be construed to allow a licensed social worker, licensed associate counselor, or licensed associate marriage and family therapist to practice within the scope of their license without a supervising practitioner or to require NJ 2[Family] FamilyCare2 to reimburse a claim for covered services submitted by a licensed social worker, licensed associate counselor, or licensed associate marriage and family therapist.
c.1 For the purpose of this section, “NJ FamilyCare” means the program established pursuant to P.L.2005, c.156 2[(C.30:4J] (C.30:4J-8 et al.).2
2. The Commissioner of Human Services shall apply for such 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.
3. The Commissioner of Human Services, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations necessary to implement the provisions of this act.
4. This act shall take effect immediately.
Requires NJ FamilyCare to reimburse claims for covered services submitted by clinical social workers, professional counselors, and marriage and family therapists under certain circumstances.