Sponsored by:
Assemblyman RONALD S. DANCER
District 12 (Burlington, Middlesex, Monmouth and Ocean)
Assemblywoman VALERIE VAINIERI HUTTLE
District 37 (Bergen)
SYNOPSIS
Makes FY 2021 supplemental appropriation of $12.5 million to DHS to increase NJ FamilyCare managed care reimbursement rate for Applied Behavior Analysis.
CURRENT VERSION OF TEXT
As introduced.
A Supplement to the Fiscal Year 2021 appropriations act, P.L.2020, c.97.
Be It Enacted by the Senate and the General Assembly of the State of New Jersey:
1. In addition to the amounts appropriated under P.L.2020, c.97, the annual appropriations act for Fiscal Year 2020-2021, there is appropriated the following sum for the purpose specified:
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54 DEPARTMENT OF HUMAN SERVICES 20 Physical and Mental Health 24 Special Health Services 7540 Division of Medical Assistance and Health Services GRANTS-IN-AID |
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22-7540 |
General Medical Services ........................................................ |
$12,500,000 |
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Total Grants-in-Aid Appropriation, Special Health Services |
$12,500,000 |
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Grants-in-Aid: |
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22 |
Medical Coverage – Title XIX Parents and Children .......................................... |
($12,500,000) |
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Of the amounts hereinabove appropriated within the General Medical Services program classification, $12,500,000 shall be allocated to increase the NJ FamilyCare reimbursement rates provided under the managed care delivery system for Applied Behavioral Analysis services rendered to NJ FamilyCare Medicaid eligible individuals under the age of 21 with a diagnosis of Autism Spectrum Disorder. The increased reimbursement rates established under this provision shall be determined by the Commissioner of Human Services and shall be subject to federal approval.
2. This bill takes effect immediately.
STATEMENT
This bill makes an FY 2021 supplemental appropriation of $12.5 million to the Department of Human Services to increase the NJ FamilyCare managed care reimbursement rate for Applied Behavior Analysis (ABA) services rendered to NJ FamilyCare Medicaid eligible individuals under the age of 21 with a diagnosis of Autism Spectrum Disorder (ASD). The bill also directs that the increased rates are to be determined by the Commissioner of Human Services and subject to federal approval.
ABA is a type of therapy that focuses on improving specific behaviors, such as social skills, communication, reading, and academics as well as adaptive learning skills, such as fine motor dexterity, hygiene, grooming, domestic capabilities, punctuality, and job competence. Therapists have used ABA to help children diagnosed with ASD and related developmental disorders since the 1960s. However, reimbursement of ABA therapy for ASD treatment services has only been covered under NJ FamilyCare since April 1, 2020 and access to providers has been a barrier for enrollees to benefit from this new service. It is the sponsor’s goal to increase the reimbursement rate as a means to increase the provider network and connect more NJ FamilyCare youth with this essential service.