Sponsored by:
Assemblywoman GARNET R. HALL
District 28 (Essex and Union)
SYNOPSIS
Requires Medicaid coverage for motorized wheelchairs for nursing facility residents under certain circumstances.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning Medicaid coverage and nursing facility residents and supplementing Title 30 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. As used in this section:
"Division" mean the Division of Medical Assistance and Health Services in the Department of Human Services.
"NJ FamilyCare" means the program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.), which includes the State's Medicaid Program and the Children's Health Insurance Program.
"Nursing facility" means a long-term care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), which has been approved by the Department of Human Services to provide care to NJ FamilyCare beneficiaries who require conventional nursing facility services.
Managed care organization means a managed care organization contracted with the division to provide benefits under the Medicaid program to an enrollee.
"Medicaid" means the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
b. Notwithstanding the provisions of any State law, rule, or regulation to the contrary, the Medicaid program and the NJ FamilyCare program shall provide coverage for a motorized wheelchair for an enrollee residing in a nursing facility under the following conditions:
(1) the enrollee is prescribed the motorized wheelchair by the enrollees licensed physician or primary healthcare provider; and
(2) the enrollee received prior authorization for the motorized wheelchair from the enrollees managed care organization.
c. An enrollee who satisfies the criteria set forth in subsection b. of this section shall be granted a possessory interest for the motorized wheelchair for as long as the enrollee requires use of the equipment. When the enrollee no longer needs such equipment, possession and control shall revert to the division. The nursing facility shall notify the enrollees managed care organization in writing when such equipment is no longer in use.
d. The Commissioner of Human Services shall apply for such State plan amendments or waivers as may be necessary to implement the provisions of this act and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.
2. The Commissioner of Human Services may adopt rules and regulations, pursuant to the Administrative Procedure Act, P.L.1968, c.410 (C.52:14B-1 et seq.), as may be necessary to implement the provisions of this act.
3. This act shall take effect on the first day of the fourth month next following the date of enactment, but the Commissioner of Human Services may take such anticipatory administrative action in advance thereof as may be necessary for the implementation of this act.
STATEMENT
This bill provides Medicaid coverage for motorized wheelchairs for nursing facility residents under certain circumstances. The bill requires the Medicaid program and the NJ FamilyCare program to provide coverage for a motorized wheelchair for an enrollee residing in a nursing facility under the following conditions: (1) the enrollee is prescribed the motorized wheelchair by the enrollees licensed physician or primary healthcare provider; and (2) the enrollee received prior authorization for the motorized wheelchair from the enrollees managed care organization.
Under the bill, the enrollee will be granted a possessory interest for the motorized wheelchair for as long as the enrollee requires use of the equipment. When the enrollee no longer needs such equipment, possession and control will revert to the division. The nursing facility will notify the enrollees managed care organization in writing when such equipment is no longer in use.
The Commissioner of Human Services will apply for such State plan amendments or waivers as may be necessary to implement the provisions of this bill and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.