This bill mandates that NJ FamilyCare reimburse inpatient providers for long-acting injectable antipsychotic drugs at the same rate as those drugs are reimbursed when administered in an outpatient setting. Specifically, it stipulates that this reimbursement must be separate from any payments made under the Diagnostic Related Group (DRG) reimbursement system, which currently determines fixed payments for inpatient services based on patient diagnoses and procedures. The bill aims to ensure that the reimbursement for these high-cost medications reflects their actual costs, thereby improving access to these essential treatments for patients with serious mental illnesses, such as schizophrenia and bipolar disorder.
Additionally, the bill requires the Commissioner of Human Services to apply for any necessary state plan amendments or waivers to implement these provisions and secure federal financial participation for state Medicaid expenditures. It also mandates the adoption of rules and regulations necessary for the bill's implementation, which is set to take effect four months after its enactment. The overall goal of the legislation is to enhance medication adherence, reduce hospitalizations, and improve clinical outcomes for individuals receiving treatment in inpatient settings.