Bill Text: NJ S1733 | 2018-2019 | Regular Session | Introduced
Bill Title: Establishes minimum Medicaid reimbursement rates for private duty nursing services.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced - Dead) 2019-06-03 - Referred to Senate Budget and Appropriations Committee [S1733 Detail]
Download: New_Jersey-2018-S1733-Introduced.html
Sponsored by:
Senator LORETTA WEINBERG
District 37 (Bergen)
SYNOPSIS
Establishes minimum Medicaid reimbursement rates for private duty nursing services.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning Medicaid reimbursement for private duty nursing 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. The hourly reimbursement rate for private duty nursing services under the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), when the services are provided in the Medicaid fee-for-service delivery system, shall be no less than $60 per hour when a registered professional nurse provides the services, and no less than $48 per hour when a licensed practical nurse provides the services.
2. Within 180 days after the enactment of this act, 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 secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.
3. The Commissioner of Human Services 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 immediately.
STATEMENT
This bill would establish minimum Medicaid reimbursement rates for private duty nursing (PDN) services. PDN services are individualized nursing services that are provided by licensed nurses, on a continuous and non-intermittent basis, to certain beneficiaries in the home setting. The bill provides that the minimum Medicaid reimbursement rate for such services is to be no less than $60 per hour when a registered professional nurse provides the services, and no less than $48 per hour when a licensed practical nurse provides the services.
Existing State regulation, at N.J.A.C.10:60-11.2, establishes a maximum Medicaid reimbursement rate for PDN services. Specifically, the regulation provides for reimbursement of PDN services at a rate of not more than $40 per hour when a registered professional nurse provides the services, and not more than $28 when a licensed practical nurse provides the services. These maximum reimbursement rates, however, are insufficient to cover the costs of service provision, and may effectively dissuade nurses from providing PDN services in the State.
The bill would require the Commissioner of Human Services to apply for such State plan amendments or waivers as may be necessary to implement the bill's provisions and secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.
