The Clinical Laboratory Services Reimbursement and Vulnerable Patient Discount Act seeks to improve 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 jeopardizing their reimbursement rates under the NJ FamilyCare program or violating existing rebate prohibitions. It modifies the reimbursement structure, stating that laboratories will be reimbursed at the lesser of the maximum fee schedule or their usual charge for the same service to the general public. This change aims to encourage laboratories to provide necessary discounts without affecting their financial viability.

Additionally, the bill mandates the dismissal of any pending audits or actions against laboratories for violations of current reimbursement policies that would now be permissible under the new provisions. It ensures that discounts offered by laboratories in compliance with the bill will not incur penalties under existing state law regarding Medicaid provider payments. Overall, the legislation is designed to enhance the ability of clinical laboratories to serve vulnerable populations while ensuring compliance with both state and federal regulations.

Statutes affected:
Introduced: 30:4D-17