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Bill

S 3438

Relates to enacting a balanced budget requirement and creates the New York state governmental accounting review board

2025 Regular Session Introduced by Andrew Gounardes and 3 co-sponsors

Requires NJ FamilyCare/Medicaid to cover motorized wheelchairs for nursing facility residents prescribed by a physician, giving the resident possessory interest while needed.

REFERRED TO FINANCE
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Bill Summary · S 3438

Summary — Senate Bill No. 3438 (as reported Feb. 3, 2025)

Note: the bill text and fiscal documents provided concern New Jersey’s Senate Bill No. 3438 (NJ FamilyCare/Medicaid).

Main purpose

Require New Jersey’s Medicaid program (NJ FamilyCare) to cover motorized wheelchairs for nursing facility residents in specified circumstances, and define possession, notification, and implementation procedures for such equipment.

Key provisions

  • Coverage requirement
    • NJ FamilyCare and the Medicaid program must provide coverage for a motorized wheelchair when an enrollee residing in a nursing facility is prescribed the device by a licensed physician or primary health care provider.
  • Possessory interest and control
    • An enrollee who meets the criteria is granted a possessory interest in the motorized wheelchair for as long as they require it.
    • If the enrollee no longer needs the equipment, possession and control revert to the Division of Medical Assistance and Health Services (the Division) in the Department of Human Services.
  • Notification requirement
    • The nursing facility, or the enrollee if the enrollee no longer resides in the facility, must notify the Division in writing when the motorized wheelchair is no longer in use.
  • Federal financing and implementation
    • The Commissioner of Human Services must apply for any State plan amendments or waivers necessary to implement the bill and to secure federal financial participation (Medicaid matching funds).
    • The Commissioner may adopt implementing rules and regulations under the Administrative Procedure Act.
  • Effective date
    • The act would take effect on the first day of the fourth month after enactment; the Commissioner may take anticipatory administrative actions beforehand.

Committee amendments (reported Feb. 3, 2025)

  • Removed prior authorization requirement from the enrollee’s managed care organization (MCO).
  • Removed the bill’s explicit definition of “managed care organization.”
  • Clarified that notification goes to the Division (not to an MCO).
  • Added language allowing the possessory interest to continue if the enrollee leaves the nursing facility so long as they remain eligible for NJ FamilyCare coverage of the device.

Who is affected

  • Primary: NJ FamilyCare/Medicaid enrollees residing in licensed nursing facilities who are prescribed motorized wheelchairs.
  • Secondary: nursing facilities (changes in billing/reimbursement practice), the Division of Medical Assistance and Health Services, and the Department of Human Services (administration, rulemaking, and federal applications).

Fiscal impact

  • Office of Legislative Services (OLS) estimate: indeterminate annual State expenditure increase (and corresponding increase in federal reimbursements).
  • Illustrative cost scenario: assuming 10–20% of the 24,417 NJ FamilyCare nursing home residents (Dec. 2024) become eligible and using current fee-for-service wheelchair reimbursement ($2,914–$3,647), total annual costs could range roughly $7.1 million to $17.8 million. State share estimated at about $3.6 million to $8.9 million; remainder would be federally matched. Actual costs are uncertain and depend on utilization, device features, and federal approval.

Legislative status (from provided record)

  • Introduced: June 13, 2024 (referred to Senate Health, Human Services & Senior Citizens Committee)
  • Reported with committee amendments: Feb. 3, 2025 (2nd Reading)
  • Referred to Senate Budget & Appropriations Committee / REFERRED TO FINANCE (dates listed Jan.–Feb. 2025)

Related/companion legislation

  • Companion assembly bill: A4690
  • Prior-session and related Senate bills listed in the record (e.g., S 2662, S 3420, etc.).

This bill changes current practice by allowing separate coverage/payment for motorized wheelchairs provided to eligible nursing facility residents (rather than treating the device cost as covered only within a static per-diem nursing facility rate), and it establishes possessory and administrative rules intended to preserve access and manage device disposition.

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

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