NJ A4012

Expands existing minimum Medicaid reimbursement rate requirements for brain injury services to include structured day program services, which were previously limited to community residential services only

Sets the reimbursement rate for Structured Day Program Services for brain injury patients equal to the average of Day Habilitation Services Tiers D and E rates used by the Division of Developmental Disabilities

Increases reimbursement from approximately $3.65 per 15 minutes of service to $9.38 per 15 minutes, matching rates for comparable developmental disability services

Applies to services provided through both Medicaid fee-for-service and managed care delivery systems for treatment of traumatic and non-traumatic brain injuries

Takes effect 30 days after enactment and applies to all Medicaid managed care contracts executed or renewed after the effective date