NJ A2064

Medicaid and NJ FamilyCare managed care organizations must offer patient-centered medical home models to primary care providers in their networks, with the Division of Medical Assistance and Health Services able to grant waivers for organizations offering alternative payment models that similarly incentivize quality care

Managed care organizations must submit annual descriptions of their payment models to the division, including financial structure, provider eligibility requirements, quality metrics, participating provider lists, and enrollee counts by county

The Division of Medical Assistance and Health Services will establish standardized quality metrics through a public stakeholder process, which managed care organizations must use when calculating provider payments under these models

Managed care organizations must submit patient-level and provider-level data on participation and performance to enable the division to evaluate the effectiveness of these payment models

The bill takes effect one year after enactment, contingent on receiving necessary federal waivers and approvals for Medicaid funding