Establishes minimum NJ FamilyCare reimbursement rate for certain out-of-state hospitals that provide services to NJ FamilyCare pediatric beneficiaries.
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed General Assembly
- To Governor
- Became Law
Overview
This bill aims to ensure that New Jersey FamilyCare pediatric beneficiaries receive adequate access to care from out-of-state hospitals. It establishes a minimum reimbursement rate of 125% of the fee-for-service rate for out-of-state hospitals that serve a significant number of NJ FamilyCare pediatric patients. The bill also strengthens network adequacy standards for managed care organizations, requiring sufficient numbers of pediatric primary and specialty care physicians and specialists within the network, and outlines a process for addressing patient and provider grievances regarding network access.
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1 on record
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