S.1073

Establishes minimum NJ FamilyCare reimbursement rate for certain out-of-state hospitals serving NJ FamilyCare pediatric beneficiaries.

The bill sets a minimum reimbursement rate for out-of-state hospitals providing care to 10,000 or more unique NJ FamilyCare pediatric beneficiaries annually. These hospitals must receive at least 125 percent of the Medicaid fee-for-service reimbursement rate in their licensed state. The legislation aims to ensure adequate pediatric care access and timely services for beneficiaries, prohibiting balance-billing and limiting cost-sharing to state law maximums. The Commissioner of Human Services is tasked with implementing necessary administrative actions and rules.