Sponsored by:
Senator PAUL A. SARLO
District 36 (Bergen and Passaic)
Senator DECLAN J. O'SCANLON, JR.
District 13 (Monmouth)
SYNOPSIS
Establishes minimum base NJ FamilyCare per diem reimbursement rate of $1,100 for special care nursing facility with neurologically impaired young adult unit.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning NJ FamilyCare reimbursement rates for certain special care nursing facilities, supplementing Title 30 of the Revised Statutes, and making an appropriation.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. Beginning January 1, 2024, the division shall reimburse a special care nursing facility, issued a certificate of need by the Department of Health as of July 1, 2023 to operate a neurologically impaired young adult unit, a base NJ FamilyCare per diem reimbursement rate that is, at a minimum, the greater of the special care nursing facility’s FY 2022 base per diem reimbursement rate or $1,100 per diem. The provision of the reimbursement rate established in this section will be contingent upon the special care nursing facility’s compliance with all applicable State and federal laws and regulations concerning licensure, patient safety, and quality of care.
b. As used in this section:
“Division” means the Division of Medical Assistance and Health Services in the Department of Human Services.
“NJ FamilyCare” means the program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.), which includes the State’s Medicaid Program and the Children’s Health Insurance Program.
“Special care nursing facility” means a nursing facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) that is not a unit attached to, or on the same campus as, a rehabilitation or acute care hospital and is not a distinct unit within a NJ FamilyCare-certified conventional nursing facility, and which has been approved by the Department of Human Services to provide care to NJ FamilyCare recipients who require specialized nursing facility services beyond the scope of a conventional nursing facility.
2. The Commissioner of Human Services shall adopt such rules and regulations, pursuant to the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et seq.), as shall be necessary to effectuate the provisions of this section.
3. The Commissioner of
Human Services shall apply for such State plan amendments or waivers as shall
be necessary to implement the provisions of this act and to ensure federal
financial participation for State expenditures under the federal Medicaid
program and the Children’s Health Insurance Program.
4. There are appropriated from the General Fund to the Department of Human Services such sums as shall be necessary to effectuate the provisions of this act.
5. This act shall take effect immediately.
STATEMENT
This bill establishes a minimum base NJ FamilyCare per diem reimbursement rate of $1,100 for special care nursing facilities which operate a neurologically impaired young adult unit. Under the bill, a special care nursing facility is defined as a nursing facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) that is not a unit attached to, or on the same campus as, a rehabilitation or acute care hospital and is not a distinct unit within a NJ FamilyCare-certified conventional nursing facility, and which has been approved by the Department of Human Services to provide care to NJ FamilyCare recipients who require specialized nursing facility services beyond the scope of a conventional nursing facility
Specifically, the bill requires the Division of Medical Assistance and Health Services in the Department of Human Services to reimburse a special care nursing facility, issued a certificate of need by the Department of Health as of July 1, 2023 to operate a neurologically impaired young adult unit, a base NJ FamilyCare per diem reimbursement rate that is, at a minimum, the greater of the special care nursing facility’s FY 2022 base NJ FamilyCare per diem reimbursement rate or $1,100 per diem. This bill applies to reimbursements beginning January 1, 2024 and only those facilities in compliance with all applicable federal and state laws and regulations concerning licensure, patient safety, and quality of care.