Senator RICHARD J. CODEY
District 27 (Essex and Morris)
Establishes minimum Medicaid and NJ FamilyCare reimbursement rate for pediatric special care nursing facilities.
CURRENT VERSION OF TEXT
An Act concerning Medicaid and NJ FamilyCare reimbursement rates for certain long-term care facilities, supplementing Title 30 of the Revised Statutes, and making an appropriation.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. The Division of Medical Assistance and Health Services within the Department of Human Services shall reimburse a pediatric skilled care nursing facility that participates in the New Jersey Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), or the New Jersey FamilyCare Program, established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.), at a base reimbursement rate of no less than $950.00 per day.
b. A pediatric skilled care nursing facility shall only be eligible to receive the minimum Medicaid and NJ FamilyCare reimbursement rate, established pursuant to this section, if the facility also is in compliance with applicable State and federal laws and regulations concerning licensure, patient safety, and quality of care.
c. As used in this section:
“Pediatric skilled care nursing facility” means a nursing facility that has been approved by the Department of Health and the Department of Human Services to provide care to New Jersey Medicaid and NJ FamilyCare enrollees, up to 21 years of age, who require specialized nursing facility services beyond the scope of a conventional nursing facility.
d. The Commissioner of Human Services shall adopt such rules and regulations, pursuant to the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et seq.), as may be necessary to implement the provisions of this section.
2. The Commissioner of Human Services shall apply for such State plan amendments or waivers as shall be necessary to implement the provisions of this act and to ensure federal financial participation for State expenditures under the federal Medicaid program and the Children’s Health Insurance Program.
3. There are appropriated from the General Fund to the Department of Human Services such sums as shall be necessary to effectuate the provisions of this act.
4. This act shall take
effect on the first day of the second month next following the date of
enactment, except the Commissioner of Human Services may take any advance
administrative action as shall be necessary for the implementation of this act.
This bill requires the Division of Medical Assistance and Health Services (DMAHS) within the Department of Human Services to establish a minimum Medicaid and NJ FamilyCare reimbursement rate of $950.00 per day for pediatric special care nursing facilities (SCNFs). Pediatric SCNFs provide specialized, long-term care and rehabilitation to medically fragile children and youth, up to 21 years of age. The bill, however, conditions the provision of this minimum reimbursement rate upon a facility’s compliance with applicable State and federal laws and regulations concerning licensure, patient safety, and quality of care. The bill additionally appropriates from the General Fund to the Department of Human Services such sums as are necessary to implement this reimbursement rate increase.
New Jersey currently has four pediatric SCNFs that participate in the State Medicaid program and the NJ FamilyCare program: the Pediatric Long Term Care Center at Children’s Specialized Hospital (Mountainside and Toms River), the Phoenix Center for Rehabilitation and Pediatrics (Haskell), and the Voorhees Pediatric Facility (Voorhees).