Sponsored by:
Assemblywoman VALERIE VAINIERI HUTTLE
District 37 (Bergen)
Assemblyman GORDON M. JOHNSON
District 37 (Bergen)
Assemblyman DANIEL R. BENSON
District 14 (Mercer and Middlesex)
Assemblyman RAJ MUKHERJI
District 33 (Hudson)
SYNOPSIS
Establishes certain requirements and conditions concerning changes to DHS reimbursement system for mental health and substance use disorder treatment services.
CURRENT VERSION OF TEXT
As reported by the Assembly Human Services Committee on May 18, 2017, with amendments.
An Act concerning reimbursement for mental health and substance use disorder treatment 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. A contract between a licensed provider of mental health or substance use disorder treatment services and the Division of Mental Health and Addiction Services or the Division of Medical Assistance and Health Services in the Department of Human Services that provides fee-for-service reimbursement for the provider to provide mental health or substance use disorder treatment services shall include provisions allowing for the provider to be reimbursed for the following services and activities:
a. providing an initial intake assessment of a patient, and separately for providing an initial psychiatric evaluation. Reimbursement for both services shall be available if both an assessment and an evaluation are performed on the same day;
b. 1[an otherwise reimbursable appointment in the event that the patient cancelled or failed to attend the appointment, and the cancellation or failure to attend was not in any way the result of a failure of the provider to uphold its obligations under the contract or its license;
c.]1 outreach services after a consumer fails to appear for a scheduled appointment to determine the cause of the missed appointment;
1[d.] c.1 transportation for staff traveling to visit a consumer at the consumer’s residence or another appropriate remote location;
1[e.] d.1 transitional planning and other engagement for a consumer who is preparing to transition, or who has recently transitioned, between an institutional setting and a community setting; and
1[f.] e.1 assistance with applications for public benefits for which a consumer may be eligible, including, but not limited to, medical assistance, nutrition assistance, and home energy assistance programs.
2. Notwithstanding any law or regulation to the contrary, neither the Division of Mental Health and Addiction Services nor the Division of Medical Assistance and Health Services in the Department of Human Services shall require prior authorization for partial care services for treatment of a substance use disorder in order to provide reimbursement for those services.
3. The Department of Human Services shall provide in-person technical support to any licensed provider of mental health or substance use disorder treatment services that, on June 30 2017, holds a contract with the Division of Mental Health and Addiction Services or the Division of Medical Assistance and Health Services in the Department of Human Services that provides cost-based reimbursement for the provider to provide mental health or substance use disorder treatment services, and that subsequently transitions to a fee-for-service reimbursement system, upon the provider’s request.
4. This act shall take effect immediately. Section 3 shall expire on June 30, 2018.