This bill amends the NJ FamilyCare program to allow reimbursement for multiple medical encounters per day at federally qualified health centers (FQHCs) for enrollees, provided certain conditions are met. Specifically, the referring health care provider must document the medical necessity for each referral to a specialty provider, and each encounter must be with a different specialty provider. The bill clarifies that it does not authorize the Commissioner of Human Services to waive or limit any federal statutes or state reimbursement methodologies related to NJ FamilyCare.
Additionally, the bill defines key terms such as "federally qualified health center" and "specialty provider," outlining the criteria that must be met for a health care provider to be classified as a specialty provider. The Commissioner of Human Services is tasked with applying for any necessary state plan amendments or waivers to implement these provisions and secure federal financial participation for state Medicaid expenditures. The act is set to take effect on the first day of the fourth month following its enactment.