SENATE HEALTH, HUMAN SERVICES AND SENIOR CITIZENS COMMITTEE

STATEMENT TO

SENATE, No. 3495

STATE OF NEW JERSEY

DATED:  MAY 11, 2023

      The Senate Health, Human Services and Senior Citizens Committee reports favorably Senate Bill No. 3495.

     This bill requires the Department of Human Services (department) to provide for the presumptive eligibility for home and community-based services under Medicaid for an individual who is:  seeking home and community-based services; awaiting an eligibility determination for Medicaid and any applicable Medicaid waiver program offering home and community-based services; and likely to be financially and clinically eligible for Medicaid and any applicable Medicaid waiver program offering home and community-based services, as determined by the department. 

     The department will provide Medicaid coverage for eligible home and community-based services provided to an individual who is granted presumptive eligibility.  Coverage will begin upon the receipt of an individual’s request for services and will end if the individual is determined clinically or financially ineligible for home and community-based services under Medicaid during the eligibility determination process.

     An individual seeking presumptive eligibility under the bill will be required to submit a request to the department in a manner and form as determined by the Commissioner of Human Services (commissioner).  The individual granted presumptive eligibility will be required to submit a completed application for Medicaid and any applicable Medicaid waiver program offering home and community-based services no later than the end of the month following the month in which presumptive eligibility is granted.  The department will provide each individual granted presumptive eligibility pursuant to this bill a written notice explaining the terms and conditions of presumptive eligibility and the services the individual will be eligible to receive.

     The commissioner will apply for such State plan amendments or waivers as may be necessary to implement the provisions of this bill and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.