NJ A4244

Establishes a Medicaid Managed Care Organization (MCO) Oversight Program within the Division of Medical Assistance and Health Services to ensure accessible, quality health care for Medicaid and NJ FamilyCare enrollees.

Requires MCO contractors to submit updated provider and beneficiary data quarterly, and mandates annual verification that at least 20% of provider information is accurate and 100% of listed providers are eligible Medicaid providers.

Imposes minimum $50,000 fines for each failure to submit required information, with potential five-year ban from contracting for MCOs that fail to pay fines after administrative hearings.

Requires MCO contractors to annually submit claims inactivity reports and verify that provider panel sizes do not exceed established limits across all patient populations.

Mandates annual reporting to the Legislature by April 1 and requires a follow-up audit by the Office of State Auditor three years after enactment; takes effect 180 days after enactment.