ASSEMBLY FINANCIAL INSTITUTIONS AND INSURANCE COMMITTEE

STATEMENT TO

SENATE, No. 2284

with committee amendments

STATE OF NEW JERSEY

DATED:  DECEMBER 4, 2014

      The Assembly Financial Institutions and Insurance Committee reports favorably and with committee amendments Senate Bill No. 2284.

      This bill requires a Medicaid managed care organization (MCO) to meet with Medicaid home health care providers of personal care assistant services and home-based supportive care services prior to any reduction in provider reimbursement rates under the MCO’s Medicaid managed care plan.

      Under the bill as amended, prior to any reduction in reimbursement rates, an MCO is required to meet individually with each of the home health care providers that, in aggregate, deliver personal care assistant services or home-based supportive care services to no fewer than 25 percent of the total clients receiving personal care assistant services or home-based supportive care services under the managed care plan, when aggregating clients enrolled in the managed care plan across the set of home health care providers.  The MCO is required to discuss with home health care providers, at any individual meetings conducted pursuant to this bill: the proposed reduction in provider reimbursement rates; and alternatives to the proposed reduction in reimbursement rates that maintain the quality of, and access to, care for affected clients.

      The MCO is also required to provide written certification to the Director of the Division of Medical Assistance and Health Services in the Department of Human Services that includes the following information: an assurance that the required meetings have been conducted with home health care providers; the name of each home health care provider attending the required meetings; the number of clients receiving personal care assistant services or home-based supportive care services, under the Medicaid managed care plan, from each home health care provider attending the required meetings; and the total number of clients receiving personal care assistant services or home-based supportive care services under the managed care plan.

      Finally, the bill stipulates that an MCO shall not reduce reimbursement rates for Medicaid personal care assistant services or Medicaid home-based supportive care services until 90 days after the written certification required by the bill is received by the Director of the Division of Medical Assistance and Health Services.

      This bill, as amended, is identical to Assembly Bill No. 3549(1R).

COMMITTEE AMENDMENTS

      The committee amended the bill to require an MCO to meet individually with certain home health care providers and have individual discussions with those home health care providers regarding reimbursement rates and alternatives to proposed reductions.