LEGISLATIVE FISCAL ESTIMATE
ASSEMBLY, No. 4810
STATE OF NEW JERSEY
221st LEGISLATURE
DATED: JULY 29, 2025
SUMMARY
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Synopsis: |
Requires NJ FamilyCare reimbursement for pediatric medication management services provided for certain children by licensed pharmacist. |
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Type of Impact: |
Annual increase in State expenditures and revenues. |
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Agencies Affected: |
Department of Human Services; Department of Law and Public Safety. |
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Office of Legislative Services Estimate |
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Fiscal Impact |
Year 1 |
Year 2 and Thereafter |
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State Expenditure Increase-NJ FamilyCare |
Indeterminate |
Indeterminate |
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State Expenditure Increase-Administrative Costs |
$607,000 |
$512,000 |
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State Revenue Increase |
$303,500 |
$256,000 |
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· The Office of Legislative Services (OLS) concludes that State service costs under the NJ FamilyCare program will increase by an indeterminate amount annually to reimburse licensed clinical pharmacists who provide comprehensive medication management services for medically complex pediatric patients. Because NJ FamilyCare payments for these services will be determined according to the terms of contracts to be entered into by the Department of Human Services and the pharmacists providing these services, the OLS lacks the informational basis to determine the amount by which NJ FamilyCare costs will increase under the bill.
· Any increase in State expenditures under the NJ FamilyCare program will be eligible for additional federal Medicaid reimbursements, thereby increasing State revenues, albeit by an indeterminate amount.
· NJ FamilyCare administrative costs will increase for the Department of Human Services and the Board of Pharmacy in the Division of Consumer Affairs to determine the educational and credentialing requirements for pharmacists providing comprehensive medication management services. The department also will incur additional administrative costs to establish a quality assurance program to monitor and evaluate the efficacy and outcomes of these services for pediatric patients. The OLS concludes the State’s administrative costs will increase by $607,000 in the first year and by $512,000 annually thereafter.
· Assuming that these NJ FamilyCare administrative costs will be eligible for federal Medicaid reimbursement, in an amount equaling 50 percent of total costs, State revenues are anticipated to increase by $303,500 in the first year following the bill’s enactment, and $256,000 in subsequent years.
BILL DESCRIPTION
The bill requires the NJ FamilyCare program to cover comprehensive medication management services provided by a licensed clinical pharmacist for a medically complex pediatric patient. Comprehensive medication management services are a standard of care by which a clinical pharmacist assesses each of a patient’s medications, including prescription and nonprescription medications, vitamins, and supplements, to determine that each is appropriate given the patient’s medical conditions and other medications taken.
The Department of Human Services will enter into value-based contracts with licensed clinical pharmacists to reimburse for comprehensive medication management services for eligible pediatric patients. The department also will establish a quality assurance program to monitor and evaluate the outcomes and efficacy of the services and ensure that these services align with the department’s value-based payment strategies.
The department and the Board of Pharmacy in the Division of Consumer Affairs will designate the educational, training, and credentialing requirements for licensed clinical pharmacists to provide the services.
The bill also amends The New Jersey Pharmacy Practice Act to specify that a licensed clinical pharmacist who satisfies the credentialing requirements to provide comprehensive medication management services will not be required to enter into a written agreement with a licensed physician in order to provide the services. The bill further amends current law to provide that the statutory provisions regulating collaborative drug therapy management will not apply to the provision of comprehensive medication management services by a licensed clinical pharmacist.
FISCAL ANALYSIS
EXECUTIVE BRANCH
None received.
OFFICE OF LEGISLATIVE SERVICES
The OLS concludes that annual State service costs will increase by an indeterminate amount for the NJ FamilyCare program, the State’s Medicaid program and the Children’s Health Insurance Program, to reimburse licensed clinical pharmacists for the provision of comprehensive medication management services for medically complex pediatric patients. Because payment rates for these services would be determined according to the terms of the contracts to be negotiated by the Department of Human Services and licensed clinical pharmacists who provide such services, the OLS lacks the informational basis to determine the amount by which NJ FamilyCare expenditures will increase under the bill. To the extent that NJ FamilyCare expenditures increase, State revenues will grow in the form of federal Medicaid reimbursements.
NJ FamilyCare administrative costs will increase for the department and the Board of Pharmacy in the Division of Consumer Affairs to determine the educational, training, and credentialing requirements that licensed clinical pharmacists must satisfy in order to provide comprehensive medication management services. The department also will incur additional administrative expenses to establish a quality assurance program to monitor and evaluate the efficacy and outcomes of these services under the bill. The OLS estimates that NJ FamilyCare administrative expenditures will increase by $607,000 for the additional staff necessary to implement these provisions in the first year following the bill’s enactment; in the second and third years following enactment, the OLS estimates that administrative costs will fall to $512,000.
Assuming that these NJ FamilyCare administrative costs will be eligible for federal Medicaid matching funds, in an amount equaling 50 percent of the total, State revenues are anticipated to increase by $303,500 in the first year following the bill’s enactment and $256,000 in subsequent years.
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Section: |
Human Services |
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Analyst: |
Senior Fiscal Analyst |
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Approved: |
Thomas Koenig Legislative Budget and Finance Officer |
This legislative fiscal estimate has been produced by the Office of Legislative Services due to the failure of the Executive Branch to respond to our request for a fiscal note.
This fiscal estimate has been prepared pursuant to P.L.1980, c.67 (C.52:13B-6 et seq.).