Sponsored by:
Senator JOSEPH F. VITALE
District 19 (Middlesex)
Co-Sponsored by:
Senator Diegnan
SYNOPSIS
Allows licensed clinical social worker to directly bill NJ FamilyCare for covered services provided to program beneficiaries.
CURRENT VERSION OF TEXT
As introduced.
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 accept and reimburse claims for services submitted by a clinical social worker provided that:
(1) the services are rendered to a NJ FamilyCare beneficiary;
(2) the services rendered are covered under the NJ FamilyCare program;
(3) the clinical social worker holds a current, valid license issued pursuant to P.L.1991, c.134 (C.45:15BB-1 et seq.); and
(4) the clinical social worker is an approved provider of services under the NJ FamilyCare program.
b. For the purpose of this section, “NJ FamilyCare” means the program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.).
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.
STATEMENT
This bill would allow a licensed clinical social worker to directly bill NJ FamilyCare for covered services provided to program beneficiaries. Specifically, the bill requires 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, to accept, and reimburse, claims for services submitted by a clinical social worker, provided that:
1) the services are rendered to a NJ FamilyCare beneficiary;
2) the services rendered are covered under the NJ FamilyCare program;
3) the clinical social worker holds a current, valid license issued pursuant to P.L.1991, c.134 (C.45:15BB-1 et seq.); and
4) the clinical social worker is an approved provider of services under the NJ FamilyCare program.