The Clinical Laboratory Services Reimbursement and Vulnerable Patient Discount Act seeks to enable clinical laboratories in New Jersey to provide discounts to certain patients, specifically those who are uninsured, underinsured, or facing financial hardship, without risking their reimbursement rates from NJ FamilyCare or breaching existing rebate prohibitions. The bill introduces definitions for key terms and establishes criteria for discount eligibility, emphasizing the need for continued access to essential laboratory services for vulnerable populations, particularly those impacted by substance use disorders.

In addition to defining discount parameters, the bill modifies current regulations to allow laboratories to charge or accept lower amounts from non-NJ FamilyCare enrollees based on demonstrated financial hardship, while ensuring that these actions do not affect their reimbursement from NJ FamilyCare. It also stipulates that any ongoing audits or actions against laboratories for prior violations of reimbursement policies will be dismissed upon the bill's enactment. Furthermore, the legislation clarifies that discounts offered in compliance with the new provisions will not be classified as illegal rebates, thereby enhancing the ability of clinical laboratories to serve at-risk populations while adhering to state and federal regulations.

Statutes affected:
Introduced: 30:4D-17