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A 2868

Increases Medicaid reimbursement for in-person partial care and intensive outpatient behavioral health and substance use disorder treatment services, and associated transportation services, for adults.

2024-2025 Regular Session Introduced by Reginald Atkins and 7 co-sponsors

A 2868 raises Medicaid payments for adults' in-person partial care and intensive outpatient services by at least 35%, and boosts transport reimbursement to $10 per one-way trip.

Introduced in the Assembly, Referred to Assembly Aging and Human Services Committee
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Bill Summary · A 2868

Summary: New Jersey A 2868 – Medicaid Reimbursement Increases for In-Person Partial Care and Intensive Outpatient Behavioral Health and SUD Services, and Transportation

Overview

A 2868 seeks to increase Medicaid reimbursement for in-person adult partial care and intensive outpatient (IOP) behavioral health and substance use disorder (SUD) treatment services, as well as associated transportation services. The bill defines key terms, mandates rate increases, and sets implementation steps including federal plan amendments, rulemaking, and an effective date.

  • Bill number: A 2868
  • Title: Increases Medicaid reimbursement for in-person partial care and intensive outpatient behavioral health and substance use disorder treatment services, and associated transportation services, for adults
  • Status: Introduced in the Assembly (January 9, 2024); referred to Assembly Aging and Human Services Committee
  • Classification/Subject: Medicaid
  • Related bill: Companion S 668

What the bill would do

  • Increase reimbursement rates for in-person partial care and intensive outpatient services provided to adults enrolled in Medicaid by at least 35% above the then-current State Medicaid rate.
  • Increase the aggregate reimbursement rate for transportation services (including mileage) to or from partial care or IOP providers to at least $10 per one-way trip.
  • Apply the rate increases to both fee-for-service and managed care Medicaid delivery systems, for services provided on or after the act’s effective date.

Key definitions (as used in the bill)

  • Adult: Individuals aged 21 years and older.
  • Intensive Outpatient Services: Comprehensive, structured, non-residential treatment for adults with severe mental illness or SUD, provided at licensed outpatient facilities for a minimum of nine hours per week.
  • Partial Care Services: Comprehensive, structured, non-residential behavioral health care and support for adults with severe mental illness or SUD, provided at licensed outpatient facilities for a minimum of two hours per week and a maximum of 25 hours per week, including services like psychiatric care, counseling, case management, and prevocational services.

Specific provisions

  • Reimbursement increase: Rates for in-person partial care and intensive outpatient services shall be no less than the applicable established State Medicaid rate as of the act’s effective date, increased by 35%. This includes per diem and hourly rates, as well as related services (e.g., intake, individual and group counseling) provided during partial care and IOP.
  • Transportation rate: Aggregate reimbursement for transportation and mileage to/from partial care or IOP providers shall be no less than $10 per one-way trip (up from the current $7 total, which previously comprised $4.50 for transportation and $2.50 for mileage).
  • Effective for services to adults: Rates apply to services provided to adult Medicaid enrollees on or after the act’s effective date.

Implementation and administration

  • State plan/waivers: The Commissioner of Human Services must pursue necessary State plan amendments or waivers to implement the act and secure federal financial participation.
  • Rulemaking: The Commissioner shall adopt rules and regulations as required under the Administrative Procedure Act to implement the act.
  • Effective date: The act takes effect on the first day of the fourth month after enactment, with possible anticipatory administrative action to facilitate implementation.

Who is affected

  • Adult Medicaid beneficiaries receiving in-person partial care or intensive outpatient behavioral health/SUD services.
  • Licensed outpatient facilities providing partial care or IOP services.
  • Transportation providers and mileage reimbursement associated with these services.
  • State Medicaid program administration (via the Department of Human Services).

Procedural notes

  • Introduced: January 9, 2024
  • Committee: Assembly Aging and Human Services
  • Related legislation: S 668 (companion bill)

Potential impact (high-level)

  • Access and continuity of care may improve for adults requiring partial care or IOP services due to higher reimbursements.
  • Providers may be more incentivized to offer or expand in-person services.
  • Transportation assistance for these services would become more financially supported, potentially reducing access barriers.
  • The bill would increase Medicaid expenditures; the state would seek federal matching funds and establish new rules to administer the higher rates.

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

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