The Healthy Smiles Act aims to improve access to pediatric dental services under the NJ FamilyCare program by increasing reimbursement rates for providers. Specifically, the bill mandates a 20 percent increase in the fee-for-service reimbursement rates for covered oral health services and supplies for children under 21 years of age, effective July 1, 2025, or 60 days after the bill's enactment, whichever is later. Additionally, the Commissioner of Human Services is required to adjust these rates annually based on changes in the Consumer Price Index for All Urban Consumers. The bill also stipulates that managed care organizations (MCOs) must provide reimbursement rates for pediatric oral health services that are equal to or greater than the fee-for-service rates.

To enforce compliance, the bill imposes civil penalties of up to $10,000 per day for MCOs that fail to adhere to the reimbursement rate requirements. The Commissioner of Human Services is tasked with ensuring that contracts with MCOs reflect these provisions and is authorized to apply for necessary state plan amendments or waivers to secure federal funding for NJ FamilyCare expenditures. The act is designed to address the disparities in dental health among New Jersey children, particularly those from low-income backgrounds, and to enhance the overall quality of oral health care available to vulnerable populations.