Establishes a Medicaid Managed Care Organization Oversight Program to ensure accessible health care for Medicaid and NJ FamilyCare enrollees.
New Jersey S1818 establishes a Medicaid Managed Care Organization (MCO) Oversight Program within the Department of Human Services to ensure accessible, quality health care for Medicaid and NJ FamilyCare enrollees. The program will verify provider panel sizes, ensure 100% of listed providers are eligible, and require annual reporting of provider and beneficiary data. The bill mandates an annual audit of MCO provider networks and requires MCO contractors to submit updated provider and beneficiary data quarterly.
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- Overview
- Core Provisions
- Implementation
- Impact
- Legal Framework
- Critical Issues
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