New Jersey Enacts Sweeping Healthcare Reforms: Enhanced Reimbursement Rates for Providers, New Regulations for Insurance Payers
New Jersey Legislature has passed a series of bills during the landmark legislative session dubbed the Golden Age of Healthcare in New Jersey. These bills amend the current healthcare laws and will help transform the healthcare sector in the state. A series of changes, including insurance coverage, provider reimbursement, mental health division programs, and prescription drugs, have been made by the legislation.
Key Changes in Healthcare Laws
- Expanded Insurance Coverage: The new legislation has made critical changes to insurance coverage. For instance, New Jersey residents should expect enhanced health insurance coverage. While Medicaid will be required to pay for fertility treatment, families and children below the age of 21 will receive coverage for hearing aids. Palliative care services will also be a mandated requirement for coverage.
- Enhanced Provider Reimbursement: Healthcare providers will also have a reason to smile because the law has called for wide-ranging changes in the manner healthcare providers are being reimbursed. This includes better reimbursement rates for healthcare providers by insurers and more flexible reimbursing options. Per diem rates have been also increased by the legislation for nursing facilities that will be strictly providing care for traumatic brain injuries.
- Mental Health Diversion Program: The state has advanced a substantial way of fostering mental health in the criminal justice system by creating a mental health diversion program. The program’s goal is to divert nonviolent offenders with mental problems to adhere to the treatment programs, rather than jailing them.
- Prior Authorization Reforms: The legislation has timely made the ways patients could endure in accommodating services from the medical facilities concerted, thus easing their hands in getting the required care.
- Regulation of Pharmacy Benefit Managers (PBMs): New Jersey will be implementing its requirements as PBMS will now have to acquire licenses and transparency standards of engaging in making the patients better access prescription drugs in the state.
These changes are likely to be highly beneficial for both healthcare professionals and patients. The former should experience enhanced reimbursement rates and a reduction in the administrative burden, while the latter is going to get better access to essential medical aid, including mental healthcare, fertility treatment, and hearing aids.
The legislature has passed several other bills as well: those addressing EMT reciprocity, cosmetology and hairstyling regulations, and the expansion of hospital-at-home programs.
Capline’s medical compliance consultancy services offer expert guidance and support to ensure your organization remains compliant with the evolving legal landscape. Our team of experienced professionals can help you understand and implement these new requirements, minimizing risks and maximizing opportunities for your organization.
Contact Capline today to learn more about how we can assist you in achieving and maintaining compliance with New Jersey’s healthcare regulations.
Source
- https://www.mondaq.com/unitedstates/healthcare/1381896/new-jersey-statutory-update–part-ii
- https://www.jdsupra.com/legalnews/new-jersey-statutory-update-part-ii-5708182/