SENATE HEALTH, HUMAN SERVICES AND SENIOR CITIZENS COMMITTEE

STATEMENT TO

SENATE, No. 2535

STATE OF NEW JERSEY

DATED:  JUNE 6, 2024

      The Senate Health, Human Services and Senior Citizens Committee reports favorably Senate Bill No. 2535.

      This bill amends existing law, which established minimum Medicaid reimbursement rates for brain injury services, to include structured day program services.  Current law is limited to community residential services.  Under existing law, “brain injury service" means community-based services, residential services, day care services, and home care services provided to a Medicaid beneficiary requiring treatment for traumatic or non-traumatic brain injuries, regardless of whether such services are provided through the Medicaid fee-for-service delivery system or the managed care delivery system.

      Specifically, the bill requires the Medicaid per diem or encounter reimbursement rates for Structured Day Program Services provided to a Medicaid beneficiary requiring treatment for a brain injury, which is currently approximately $3.65 for every 15 minutes of service, when such services are provided by an approved brain injury service provider, to be equal to the average of the reimbursement rates for Tier D and Tier E Day Habilitation Services provided to an eligible Medicaid beneficiary by the Division of Developmental Disabilities in the Department of Human Services, which is currently $9.72 for every 15 minutes of service.