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S 2504

Relates to increasing fines for certain speed camera violations

2025 Regular Session Introduced by Andrew Gounardes

NJ Medicaid must pay at least 100% of Medicare Part B rates for primary care and mental health services starting 7/1/2024, boosting access and provider participation.

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Bill Summary · S 2504

Summary — S.2504 (as reported by Senate Health, Human Services & Senior Citizens Committee)

Note up front: the documents supplied appear to include material from multiple, different bills (including a Massachusetts docket and an unrelated title about speed‑camera fines). The substantive committee report and bill text summarized below correspond to the New Jersey Senate bill S2504 (health care / Medicaid reimbursement). Please verify the jurisdiction/version you intend if you need a single definitive legislative text.

Main purpose

Require New Jersey Medicaid reimbursement rates for specified primary care and mental health services to be set no lower than 100% of Medicare Part B payment rates, beginning July 1, 2024 and annually thereafter — with the goal of improving provider participation, access, and quality of care for Medicaid beneficiaries.

Key provisions

  • Rate parity: Commencing July 1, 2024 (committee amendment), and annually thereafter, Medicaid reimbursement for covered primary care and mental health services must be at least 100% of the payment rate under Medicare Part B.
  • Definitions:
    • Primary care services: services as defined in section 1202 of the federal Health Care and Education Reconciliation Act of 2010; provided by physicians whose primary specialty is family medicine, general internal medicine, general pediatrics, or obstetrics/gynecology; by advanced practice nurses, physician assistants working in those areas; and by licensed midwives.
    • Mental health services: services for mental illness, emotional disorders, or substance use disorder delivered in traditional, integrated behavioral health, or collaborative care settings; providers include the primary care categories above and behavioral health specialties (licensed clinical social workers, psychologists, licensed professional counselors, licensed marriage and family therapists, licensed clinical alcohol and drug counselors, psychiatrists).
  • Non‑retrogression: The statute is not to be interpreted to require a reduction in any Medicaid reimbursement rate below the previous fiscal year’s level for the same service.
  • Scope: Applies to services reimbursed under both Medicaid fee‑for‑service and Medicaid managed care systems and to services delivered by approved Medicaid providers.
  • Implementation and oversight:
    • Commissioner of Human Services must apply for necessary state plan amendments or waivers to secure federal matching funds.
    • Commissioner must adopt implementing rules and regulations.
    • Within one year of the act’s effective date, the Commissioner must report to the Governor and Legislature on implementation, including data on access and quality changes and recommendations for further rate enhancements, especially in underserved areas.

Who is affected

  • Medicaid beneficiaries (potentially improved access to primary care and mental health treatment).
  • Medicaid providers delivering primary care and mental health services (physicians, APRNs, PAs, midwives, LCSWs, psychologists, counselors, MFTs, addiction counselors, psychiatrists) — likely to see higher reimbursement and potentially increased participation.
  • State Medicaid program and budget: higher payment rates will affect Medicaid expenditures; the bill requires pursuing federal financial participation but may increase state and federal outlays.
  • Medicaid managed care organizations, which will need to adjust payment arrangements to meet parity.

Potential impacts and considerations

  • Access & workforce: Higher rates tied to Medicare may attract or retain providers in Medicaid networks, improving appointment availability and continuity of care.
  • Cost: Expect increased Medicaid spending. Exact fiscal impact depends on utilization, baseline payment gaps, and federal match on any increased spending.
  • Administrative: Requires regulatory changes, potential renegotiation of managed‑care contracts, and submission/approval of state plan amendments/waivers.
  • Quality measurement: The required report should produce data to assess whether rate changes translate into measurable access and quality improvements.

Procedural / timeline notes

  • Committee amendment moved the start date to July 1, 2024 (from an earlier draft date of July 1, 2023).
  • The bill directs the Commissioner to report within one year after the law’s effective date.
  • Provided materials include multiple filing dates and references to other jurisdictions — confirm which S.2504 (state and session) you are tracking before relying on this summary for action.

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

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