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Bill

S 3011

"Healthy Smiles Act"; increases NJ FamilyCare fee-for-service reimbursement rates for pediatric dental services; requires NJ FamilyCare managed care rates for identical services be no less than fee-for-service rates.

2026-2027 Regular Session Introduced by Renee Burgess and 4 co-sponsors

Raises NJ Medicaid pediatric dental reimbursement rates and requires managed care parity with fee-for-service rates to expand provider participation and children's access to dental care.

Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee
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Bill Summary · S 3011

Legislative bill overview

S 3011 increases reimbursement rates for pediatric dental services under New Jersey's FamilyCare program (Medicaid) and mandates that managed care organizations pay rates no lower than the fee-for-service rates. The bill aims to improve access to dental care for low-income children by making these services more financially viable for dental providers.

Why is this important

Pediatric dental care access is a significant problem in Medicaid populations, with many providers declining to serve these patients due to low reimbursement rates. By raising rates and ensuring parity between payment models, this bill could expand the number of dentists willing to treat FamilyCare-eligible children, improving preventive care and early intervention in oral health.

Potential points of contention

  • Cost to the state: Increased reimbursement rates will raise program expenses; the bill doesn't specify funding mechanisms or projected costs, which may face budget scrutiny
  • Managed care organization concerns: Requiring MCOs to match fee-for-service rates could increase their administrative costs and potentially reduce their profit margins, potentially facing industry opposition
  • Adequacy of rate increases: The bill doesn't specify the magnitude of increases; stakeholders may dispute whether proposed rates are sufficient to meaningfully improve provider participation

Compiled from official sources — confirm details with the bill’s official record.

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