NJ A4863

NJ FamilyCare (Medicaid/CHIP) must reimburse federally qualified health centers (FQHCs) for multiple medical encounters per day for the same enrollee, provided each visit is with a different specialty provider and the referring provider documents medical necessity

Specialty providers are defined as licensed physicians who are board-certified, fellows of specialty colleges, completing specialty training, hold hospital staff appointments with specialty privileges, or are recognized by peers as specialists

FQHCs are community-based health care providers in medically underserved areas meeting federal Social Security Act criteria under 42 U.S.C. s.1396(d)

The Commissioner of Human Services must apply for federal waivers or state plan amendments necessary to implement the law and secure federal Medicaid matching funds

The bill takes effect on the first day of the fourth month following enactment