New Jersey 2026-2027 Regular Session

New Jersey Senate Bill S438

Introduced
1/13/26  
Refer
1/13/26  
Report Pass
5/11/26  

Caption

Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.

Impact

If enacted, the bill will amend P.L.2022, c.78, which currently outlines reimbursement rates based only on community residential services. The proposed changes will ensure that the Medicaid reimbursement rates for structured day program services are set at a minimum equivalent to the average rates for Day Habilitation Services, effectively raising the reimbursement from $3.65 to $9.09 per 15 minutes. This financial improvement is expected to bolster the viability of these programs, potentially increasing their availability and quality, thereby contributing positively to the recovery process for Medicaid beneficiaries with brain injuries.

Summary

Senate Bill S438 establishes minimum Medicaid reimbursement rates for structured day program services provided to beneficiaries eligible for brain injury services. This legislation is a significant amendment to existing laws concerning Medicaid reimbursement, particularly focusing on ensuring equitable compensation for services that assist individuals recovering from brain injuries. The bill aims to enhance the financial support available for structured day programs, expanding the scope of services recognized under Medicaid for individuals with brain injuries.

Contention

Discussions around S438 may center on the implications of increased reimbursement rates for both service providers and state spending. Proponents argue that the bill is a necessary step to improve the quality and availability of services for a vulnerable population, while critics might raise concerns regarding budget constraints and the overall impact on state healthcare funding. The balance between ensuring adequate support for individuals with brain injuries and managing the fiscal responsibilities of the state will likely be points of contention during legislative discussions.

Companion Bills

NJ S2535

Carry Over Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.

NJ A4012

Carry Over Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.

NJ A4485

Same As Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.

Similar Bills

NJ A4485

Establishes minimum Medicaid reimbursement rate for structured day program services provided to beneficiary eligible for brain injury services.

CT HB05561

An Act Concerning A Five-year Medicaid Rate Review, Dental Representation On A Medical Assistance Oversight Council, Biomarker Testing And Opioid Prescription Coverage Requirements And A Study Concerning Payment Of Spouses For State-subsidized Home Care.

HI SB2089

Relating To Mental Health.

NJ S3802

Requires Medicaid reimbursement rates for certain primary and mental health care services match reimbursement rates under Medicare.

NJ A4265

Requires Medicaid reimbursement rates for certain primary and mental health care services match reimbursement rates under Medicare.

NJ A985

"Medicaid Transportation Brokerage Program Oversight and Accountability Act"; establishes vehicle, staffing, and performance standards, and review and reporting requirements for non-emergency medical transport provided under State's non-emergency medical transportation brokerage program.

NJ S1774

Establishes minimum Medicaid reimbursement rates for certain ambulance transportation services.

HI SB2208

Relating To Pharmacy Benefit Managers.