The Clinical Laboratory Services Reimbursement and Vulnerable Patient Discount Act is designed to enhance access to laboratory services for uninsured, underinsured, and vulnerable patients in New Jersey. The bill allows clinical laboratories to offer discounts to certain patients based on demonstrated financial hardship without affecting their reimbursement rates under the NJ FamilyCare program or violating existing rebate prohibitions. It amends the current reimbursement policy under N.J.A.C.10:61-1.7, stating that reimbursement for NJ FamilyCare services will be the lesser of the maximum fee schedule or the laboratory's usual charge to the general public. This change aims to encourage laboratories to provide necessary financial assistance to those in need.

Additionally, the bill mandates the dismissal of any pending audits or actions against laboratories for violations of the previous reimbursement policy that are now permissible under the new provisions. It ensures that discounts offered in compliance with the bill will not incur penalties under existing state law regarding Medicaid provider payments. The Department of Human Services is responsible for adopting the necessary rules and regulations to implement the act, which will take effect immediately upon passage.

Statutes affected:
Introduced: 30:4D-17