Bill Text: NJ A2116 | 2012-2013 | Regular Session | Introduced
Bill Title: Requires HMOs that contract with DHS to reimburse hospitals for emergency services based on cost of those services.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Failed) 2012-03-05 - Withdrawn from Consideration [A2116 Detail]
Download: New_Jersey-2012-A2116-Introduced.html
Sponsored by:
Assemblywoman NANCY F. MUNOZ
District 21 (Morris, Somerset and Union)
SYNOPSIS
Requires HMOs that contract with DHS to reimburse hospitals for emergency services based on cost of those services.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning emergency services for medical assistance recipients and supplementing Title 30 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. The Commissioner of Human Services shall require a health maintenance organization that contracts with the Department of Human Services to provide health care services for recipients of medical assistance, pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.) or P.L.2005, c.156 (C.30:4J-8 et seq.), to reimburse a general hospital for services provided to a covered patient, who is such a recipient, in its emergency department based upon the cost of the services actually provided, rather than the patient's diagnosis at the time of discharge from the emergency department.
2. The Commissioner of Human Services, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations necessary to effectuate the purposes of this act.
3. This act shall take effect on the 180th day after enactment, but the Commissioner of Human Services may take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of the act.
STATEMENT
This bill requires a health maintenance organization that contracts with the Department of Human Services to provide health care services for recipients of Medicaid or the NJ FamilyCare Program to reimburse a general hospital for services provided to a covered Medicaid or NJ FamilyCare patient in its emergency department based upon the cost of the services actually provided, rather than the patient's diagnosis at the time of discharge from the emergency department.
The bill takes effect on the 180th day after enactment, but authorizes the Commissioner of Human Services to take anticipatory administrative action in advance as necessary for its implementation.
