Bill
S 4656
Raises revenues for the Health Care Subsidy Fund by lowering ambulatory facility fees, removing exemptions, expanding the assessment, and increasing hospital admissions charges to
Below is a clear, objective summary based on the documents you provided. Note: the supplied materials appear to mix metadata from different measures (a short title referencing a retirement-service-credit matter and sponsor/legislative-action entries that look federal), while the text and fiscal note you supplied describe a New Jersey state bill titled the "Healthcare Finance Enhancement Act." I summarize the Healthcare Finance Enhancement Act below and then note the discrepancies at the end.
Summary — “Healthcare Finance Enhancement Act” (Senate No. 4656, reprint SBA 6/26/25)
Purpose
- To modify how New Jersey assesses fees on ambulatory care facilities and to raise and expand the hospital admission charge in order to increase revenues deposited in the Health Care Subsidy Fund and to generate additional federal Medicaid matching funds.
Key provisions
- Ambulatory care facility assessment
- Lowers the assessment rate from 2.95% to 2.5% effective FY 2026.
- Removes the statutory per‑facility cap of $350,000 on the assessment beginning FY 2026.
- Eliminates the current exemption for surgical practices beginning FY 2026 (making surgical practices subject to assessment).
- Extends the assessment to ambulatory care facilities with gross annual receipts under $300,000 beginning in FY 2027.
- Committee amendment: requires facilities that had been exempt prior to FY 2026 to report FY 2026 gross receipts from their operating‑room services; the amendment also defines “operating room services.”
- Hospital admission charge
- Increases the per adjusted admission charge from $10 to $12.50 effective July 1, 2025.
- Expands the charge to apply to non‑public (private) psychiatric hospitals.
Fiscal impact (Office of Legislative Services — OLS)
- Estimated minimum State revenue increase: $63.7 million in Year 1 (FY 2026) and $63.8 million in Years 2 and 3.
- Of that amount, roughly $21.0–$21.1 million is increased State fee revenue; the remainder (about $42.7 million) is federal Medicaid matching funds triggered by the fee revenue.
- The ambulatory care facility assessment changes account for the majority (~$50.7M in FY 2026; $50.8M thereafter).
- Hospital admission charge increase is estimated to add about $13.0M annually (approximately $8.7M of that as federal match).
- The OLS flags additional indeterminate revenue from newly‑taxed surgical practices and from applying the admission charge to private psychiatric hospitals (data on number/receipts not publicly available).
- Department of Health (DOH) administrative costs will increase by an indeterminate amount to hire staff for administration and oversight.
Who is affected
- Ambulatory care facilities statewide, including small facilities previously below the $300,000 threshold and surgical practices (which lose their exemption).
- Hospitals, including non‑public psychiatric hospitals newly subject to the admission charge.
- The Health Care Subsidy Fund (receives assessment/charge revenues) and the State Medicaid program (impacted by federal matching).
Procedural/timeline notes and status
- Committee amendments reported by the Senate Budget and Appropriations Committee (6/26/2025) and reprint (SBA 6/26/25) reflect the provisions summarized above.
- Fiscal note dated July 3, 2025 (OLS) details the revenue and cost estimates.
- The documents supplied include mixed legislative metadata (see below); please confirm whether you want a summary of this New Jersey bill (healthcare finance changes) or another S.4656 referenced by the title/sponsors.
Discrepancies in provided materials (important)
- The top-line title you supplied (“Relates to state police retirement service credit for Michael V. Layman”) does not match the text/fiscal note and committee statement, which pertain to the Healthcare Finance Enhancement Act affecting ambulatory care assessments and hospital admission charges in New Jersey.
- Sponsor names and some legislative actions in your list (e.g., Chuck Grassley; Homeland Security & Governmental Affairs committee entries) appear to refer to a different bill with the same number in another jurisdiction (federal Senate), not the New Jersey measure summarized above.
- If you intended the retirement-service-credit or a federal S.4656, or want the other companion/related bills summarized, please confirm or provide the correct document/version so I can prepare an accurate summary for that measure.
Compiled from official sources — confirm details with the bill’s official record.
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