The Clinical Laboratory Services Reimbursement and Vulnerable Patient Discount Act is designed to enhance access to healthcare for vulnerable populations in New Jersey by allowing clinical laboratories to offer discounts to certain patients without risking their reimbursement rates under the NJ FamilyCare program or breaching existing rebate prohibitions. The bill defines terms such as "financial hardship" and emphasizes the importance of laboratories in serving uninsured and underinsured individuals. Currently, laboratories face restrictions that prevent them from charging 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 introduces provisions that 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 impact their NJ FamilyCare reimbursement. It clarifies that discounts offered in compliance with the new regulations will not be considered illegal rebates, thus encouraging laboratories to provide essential services. Additionally, the bill mandates the dismissal of any pending audits or actions against laboratories for violations of the current reimbursement policy that are now permissible under the new provisions. The Department of Human Services will be responsible for implementing the necessary rules and regulations, and the act will take effect immediately upon passage.

Statutes affected:
Introduced: 30:4D-17