Makes certain changes to regulation of health care service firms.

2026-2027 Regular Session Introduced by Chris DePhillips and 4 co-sponsors

Raises Medicaid audit threshold to $500k, tightens reporting with a < $10M trigger, and allows out-of-state auditors to strengthen enforcement for health care firms.

Substituted by S3463 (1R)

Summary of Assembly Bill No. 4790 (A-4790) – 2026, New Jersey

Purpose and intent

A-4790, reported favorably by the Assembly Health Infrastructure Committee, aims to modify the regulation of health care service firms operating in New Jersey. The bill focuses on tightening and clarifying audit and reporting requirements related to Medicaid personal care assistance services and overall financial disclosures for these firms. The measure is identical to Senate Bill S-3463.

Key provisions

Medicaid audit threshold for personal care assistance services

Increases the annual Medicaid reimbursement threshold that triggers an audit for health care service firms from $250,000 to $500,000 in reimbursements.

Audit submission deadline

Requires health care service firms to submit audited financial information no later than September 30 of the calendar year in which the audit is due.

Compensation threshold for reporting

Revises the reporting threshold from a range between $1 million and $10 million to a single threshold of less than $10 million. This appears to broaden the scope of entities required to report.

Content of the health care service firm report

Updates the information that must be included in the firm’s required report, aligning it with the revised thresholds and reporting expectations (specific items are not enumerated in the summary).

Corrective action

Establishes provisions for corrective action in certain cases where firms fail to meet requirements or standards, indicating a mechanism to address noncompliance.

Audit authority and location

Authorizes audits to be conducted by out-of-State accountants, expanding who may perform the audit work.

Affected entities and impacts

Health care service firms that provide Medicaid-funded personal care assistance and related services will experience:

Higher audit trigger threshold (potentially fewer audits based on reimbursement amount).
Earlier audit submission timelines.
Expanded reporting obligations (lower financial threshold for reporting).
Clearer pathways for corrective action and enforcement.
Flexibility for audits to be performed by out-of-State CPAs/accountants.

Medicaid program administration and state regulators will gain updated criteria for auditing and oversight, potentially affecting compliance monitoring and enforcement processes.

Procedural and timeline aspects

The bill specifies annual financial audits with a due date of September 30.

It clarifies reporting thresholds and content, and introduces corrective-action provisions.

It permits out-of-state auditors to conduct audits, which may affect scheduling, coordination, and oversight.

Status

Introduced and referred to the Assembly Health Infrastructure Committee (March 19, 2026).

Reported favorably by the committee on June 1, 2026; same-session companion Senate bill S-3463 reported as well.

If enacted, the changes are designed to streamline enforcement, clarify reporting expectations, and adjust audit risk exposure for health care service firms participating in Medicaid personal care assistance in New Jersey.