The "Healthy Smiles Act" aims to enhance pediatric dental care accessibility under the NJ FamilyCare program by increasing reimbursement rates for oral health services. Specifically, the bill mandates a 20 percent increase in fee-for-service reimbursement rates for covered pediatric dental services starting July 1, 2025, or 60 days after the bill's enactment, whichever is later. Additionally, the Commissioner of Human Services is tasked with adjusting 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, with penalties of up to $10,000 per day for non-compliance.

The legislation recognizes the critical need for improved oral health services for children, particularly in light of disparities in dental health among low-income and minority populations in New Jersey. By addressing the long-standing issue of low reimbursement rates, the Healthy Smiles Act seeks to ensure that vulnerable children enrolled in NJ FamilyCare can access necessary dental care, thereby supporting their overall health and well-being. The bill also includes provisions for the Commissioner to apply for necessary state plan amendments or waivers to secure federal funding for these initiatives.