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

To facilitate this, the bill allows laboratories to charge or accept a lesser amount for services from non-NJ FamilyCare enrollees based on demonstrated financial hardship, while ensuring compliance with federal regulations. It amends existing laws to clarify that discounts provided under this new legislation will not be classified as rebates, thus protecting laboratories from penalties. Additionally, the bill mandates the Department of Human Services to adopt necessary regulations for implementation and dismisses any ongoing actions against laboratories for previous violations of the now-modified regulations. Overall, this legislative change aims to improve access to care for vulnerable populations while ensuring compliance with state and federal laws.

Statutes affected:
Introduced: 30:4D-17