Sponsored by:
Senator JOSEPH F. VITALE
District 19 (Middlesex)
Senator NILSA CRUZ-PEREZ
District 5 (Camden and Gloucester)
SYNOPSIS
Increases Medicaid reimbursement rates for certain evidence-based behavioral health services; designated as the Mental Health Access Act.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning behavioral health services, designated as the Mental Health Access Act, 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. The reimbursement rate for a behavioral health care service provided to an adult or a child that is billed to the State Medicaid program shall be no less than the Medicare reimbursement rate for the service, provided the following conditions are met:
(1) The behavioral health care service is evidence-based;
(2) The service is limited to individual or group counseling provided in an outpatient setting; and
(3) The billing provider is a substance abuse treatment facility licensed by the Department of Human Services or a person licensed or otherwise authorized pursuant to Title 45 of the Revised Statutes to practice a health care profession.
b. As used in this section:
“Behavioral health care service” means a procedure or service for the treatment of mental illness, emotional disorders, or drug or alcohol abuse rendered by a person licensed or otherwise authorized pursuant to Title 45 of the Revised Statutes to practice a health care profession.
“Evidence-based” means an intervention that is included in the National Registry of Evidence-based Programs and Practices published by the federal Substance Abuse and Mental Health Services Administration, or meets other criteria established by the Commissioner of Human Services, in consultation with the Commissioner of Children and Families, for evidence-based treatment.
“Medicaid” means the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
“Medicare” means the federal Medicare program established pursuant to Title XVIII of the federal Social Security Act (42 U.S.C.s.1395 et seq.).
2. The Commissioner of Human Services shall apply for such State plan amendments or waivers as may be necessary to implement the provisions of this act and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.
3. The Commissioner of
Human Services and the Commissioner of Children and Families shall adopt rules
and regulations pursuant to the "Administrative Procedure Act"
P.L.1968, c.410 (C.52:14B-1 et seq.) to effectuate the purposes of this act.
4. This act shall take effect on the first day of the fourth month next following the date of enactment, and shall apply to all services provided on or after the effective date, except that the Commissioner of Human Services and the Commissioner of Children and Families may take any anticipatory administrative action in advance as shall be necessary for the implementation of this act.
STATEMENT
This bill, designated as the Mental Health Access Act, would increase Medicaid reimbursement rates for certain evidence-based behavioral health services under the State Medicaid program.
Under the bill, reimbursement rates could be no less than the Medicare rate for the service, provided that the service meets certain criteria.
Specifically, the bill would provide for increased reimbursement to licensed providers for individual or group counseling programs that are included in the National Registry of Evidence-based Programs and Practices published by the federal Substance Abuse and Mental Health Services Administration, or meet other criteria established by the Commissioner of Human Services, in consultation with the Commissioner of Children and Families, for evidence-based treatment.
The bill would take effect on the first day of the fourth month next following the date of enactment, and would apply to all services provided on or after the effective date.