Establishes minimum Medicaid and NJ FamilyCare reimbursement rate for pediatric special care nursing facilities.

2024-2025 Regular Session Introduced by Reginald Atkins and 5 co-sponsors

Sets a $950/day minimum Medicaid/NJ FamilyCare rate for pediatric skilled nursing facilities to cover long‑term care for medically fragile children, affecting 4 NJ facilities.

Passed Assembly (73-0-0)

#healthfac #healthinsur #medicaid

Main purpose

A2940 requires the Division of Medical Assistance and Health Services (DMAHS) in the Department of Human Services to set a minimum Medicaid and NJ FamilyCare base reimbursement rate of $950.00 per day for pediatric skilled care nursing facilities (SCNFs). The intent is to ensure a floor reimbursement that supports specialized, long‑term nursing and rehabilitation care for medically fragile children and youth (up to age 21).

Key provisions

Establishes a minimum base reimbursement rate of $950.00 per day for pediatric SCNFs that participate in Medicaid or NJ FamilyCare.

Eligibility for the minimum rate is conditioned on facility compliance with applicable State and federal licensure, patient safety, and quality‑of‑care laws and regulations.

Defines “pediatric skilled care nursing facility” as a nursing facility approved by the Departments of Health and Human Services to provide services to Medicaid/NJ FamilyCare enrollees up to age 21 who require services beyond a conventional nursing facility.

Requires the Commissioner of Human Services to adopt rules and regulations (per the Administrative Procedure Act) to implement the law.

Directs the Commissioner to apply for any State plan amendments or waivers necessary to secure federal financial participation (Medicaid and CHIP).

Appropriates from the General Fund such sums as are necessary to implement the increased reimbursement rate.

Effective date: first day of the second month after enactment; allows the Commissioner to take advance administrative actions to implement the law.

Who is affected

Pediatric SCNFs participating in New Jersey Medicaid and NJ FamilyCare — presently four facilities: Children’s Specialized Hospital (Mountainside and Toms River), Voorhees Pediatric Facility (Voorhees), and The Phoenix Center for Rehabilitation and Pediatrics (Haskell).

Medicaid/NJ FamilyCare program (Department of Human Services) and State budget/funding mechanisms.

Indirectly, medically fragile children and youth receiving care and the families/caregivers who rely on those services.

Fiscal impact (Office of Legislative Services)

Estimated annual increase in NJ FamilyCare expenditures: approximately $4.4 million.

Estimated additional federal Medicaid/CHIP reimbursements: approximately $2.3 million.

Net annual State (General Fund) cost increase to DHS: approximately $2.1 million.

OLS assumptions include a 53% aggregate federal match rate and that ~40% of beds at affected facilities are occupied by NJ FamilyCare beneficiaries. Two of the four facilities would require rate increases to reach the $950/day floor under current rates.

Procedural/timeline notes

Referred to multiple Assembly committees in 2024 (Aging & Human Services; Health; Appropriations). Reported favorably by committees and passed the Assembly on December 22, 2025 (73–0–0).

Requires administrative rulemaking and any necessary federal approvals (State plan amendments/waivers) before federal reimbursement applies.

Companion Senate bill S2472 tracks the same policy.

Bill