Sponsored by:
Senator LORETTA WEINBERG
District 37 (Bergen)
Senator NILSA CRUZ-PEREZ
District 5 (Camden and Gloucester)
SYNOPSIS
Establishes minimum Medicaid reimbursement rate for personal care services.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning Medicaid reimbursement for personal care services and supplementing Title 30 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. The hourly reimbursement rate for personal care services within the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), whether the services are provided in the Medicaid fee-for-service delivery system or through a managed care delivery system, shall be no less than $15.50 per hour, except that this amount shall be adjusted on July 1 of every fifth calendar year following the effective date of this act in direct proportion to the rise or fall in the Consumer Price Indices average for all urban wage earners for the New York metropolitan and the Philadelphia metropolitan regions as reported by the Bureau of Labor Statistics of the United States Department of Labor during the last full calendar year preceding the date upon which the adjustment is made.
2. This act shall take effect immediately, and shall apply to services provided on or after the effective date of this act and to any Medicaid managed care contract executed or renewed on or after the effective date of this act.
STATEMENT
This bill would set a minimum reimbursement rate of $15.50 per hour for Medicaid personal care services. The minimum rate would apply whether the services are provided in the Medicaid fee-for-service delivery system or through a managed care delivery system. The bill would also require that the minimum hourly rate be increased every five years based in direct proportion to the rise or fall in the Consumer Price Indices average for all urban wage earners for the New York metropolitan and the Philadelphia metropolitan regions as reported by the Bureau of Labor Statistics of the United States Department of Labor during the last full calendar year preceding the date upon which the adjustment is made.
The reimbursement rate for personal care services in the Medicaid fee-for-service program has been $15.50 for several years. However, the shift of most Medicaid personal care services to a managed care delivery system has allowed private managed care organizations to unilaterally reduce reimbursement rates to already struggling provider agencies and health care workers.