This bill establishes a Medicaid Managed Care Organization (MCO) Oversight Program within the Division of Medical Assistance and Health Services in the Department of Human Services. The program aims to ensure accessible and quality health care for individuals enrolled in the NJ FamilyCare and Medicaid programs. Following an audit that revealed significant deficiencies in the MCOs' provision of care, including inadequate access to hospital services and inaccurate provider directories, the bill mandates that MCO contractors submit updated provider and beneficiary data quarterly. It also requires the sharing of beneficiary information with county welfare offices to enhance enrollment processes and improve network adequacy.

To enhance accountability, the bill introduces penalties for MCO contractors that fail to comply with data submission requirements, imposing a minimum fine of $50,000 for each violation. Additionally, the MCO Oversight Program will implement an independent verification system to ensure the accuracy of provider information and monitor provider panel sizes to prevent overcrowding. An annual report will be submitted to the Legislature, and a follow-up audit by the Office of State Auditor is mandated three years post-enactment to assess the effectiveness of the oversight measures.