LEGISLATIVE FISCAL ESTIMATE
SENATE, No. 3969
STATE OF NEW JERSEY
220th LEGISLATURE
DATED: JUNE 23, 2023
SUMMARY
Synopsis: Allows for credit against contract cost for primary care services
managed by health care provider for public employees and their
dependents; allows referrals to other providers that have contractual
relationship with such health care provider.
Type of Impact: Annual revenue increase for local governments.
Agencies Affected: Local governments.
Office of Legislative Services Estimate
Annual Fiscal Impact
Local Government Revenue Increase Indeterminate
 The Office of Legislative Services (OLS) estimates that the bill will result in an indeterminate
annual revenue increase for local governments in the State that operate medical homes and are
part of the State Health Benefits Program or the School Employees’ Health Benefits Program.
BILL DESCRIPTION
The bill allows a health benefits company that is managing a medical home under contract with
a public employer to provide a credit to that public employer toward the cost of the contract for
health care services provided by its providers to its public employees and their dependents. The
credits would be derived from medical reimbursements to the providers with whom a health
insurance carrier also has a contractual relationship.
If provided, the amount of the credit permitted toward the cost of the contract shall not exceed
the amount of the payments received by the health benefits company from payments from
insurance carriers for claims submitted for provider services rendered to public employees and
their dependents.
Office of Legislative Services Legislative Budget and Finance Office
State House Annex Phone (609) 847-3105
P.O. Box 068 Fax (609) 777-2442
Trenton, New Jersey 08625 www.njleg.state.nj.us
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FISCAL ANALYSIS
EXECUTIVE BRANCH
None received.
OFFICE OF LEGISLATIVE SERVICES
The OLS estimates that the bill will result in an indeterminate annual revenue increase for local
governments in the State that operate medical homes and are part of the State Health Benefits
Program or the School Employees’ Health Benefits Program. The number of local governments
affected by the bill is not available.
Section: Commerce, Labor, and Industry
Analyst: John Gaudioso
Assistant Fiscal Analyst
Approved: Thomas Koenig
Legislative Budget and Finance Officer
This legislative fiscal estimate has been produced by the Office of Legislative Services due to the
failure of the Executive Branch to respond to our request for a fiscal note.
This fiscal estimate has been prepared pursuant to P.L.1980, c.67 (C.52:13B-6 et seq.).