The Clinical Laboratory Services Reimbursement and Vulnerable Patient Discount Act seeks to enable clinical laboratories in New Jersey to provide discounts to patients facing financial hardship without risking their reimbursement rates under the NJ FamilyCare program or breaching existing rebate prohibitions. The bill defines essential terms and emphasizes the importance of laboratories in serving vulnerable populations, including the uninsured and underinsured. Currently, reimbursement policies prevent laboratories from offering lower rates to uninsured patients without affecting their NJ FamilyCare claims, which has raised concerns about access to necessary services.

To address these challenges, the bill allows laboratories to offer discounts based on demonstrated financial hardship while ensuring compliance with federal regulations. It specifies that discounts for non-NJ FamilyCare enrollees will not impact reimbursement rates and mandates the dismissal of any pending audits against laboratories for violations of the previous policy. Furthermore, the bill clarifies that discounts compliant with the new regulations will not be considered illegal rebates. Overall, the legislation aims to improve access to care for underserved individuals while maintaining adherence to state and federal laws.

Statutes affected:
Introduced: 30:4D-17