New Jersey A 2266: Provides for oversight of DHS contracts with providers serving persons with developmental disabilities.

Bill Text

A2266 

ASSEMBLY, No. 2266 

STATE OF NEW JERSEY

222nd LEGISLATURE

� 

PRE-FILED FOR INTRODUCTION IN THE 2026 SESSION

Sponsored by:

Assemblywoman MARGIE DONLON, M.D.

District 11 (Monmouth)

Assemblywoman LUANNE M. PETERPAUL

District 11 (Monmouth)

SYNOPSIS

���� Requires Medicaid reimbursement of mental health 
rehabilitation services provided via clubhouse program.

CURRENT VERSION OF TEXT 

���� Introduced Pending Technical Review by Legislative 
Counsel.

�� 

An Act concerning Medicaid reimbursement for clubhouse mental 
health rehabilitation services and amending P.L.1968, c.413.

���� Be It 
Enacted by the Senate and General Assembly of 
the State of New Jersey:

���� 1.� Section 6 of P.L.1968, 
c.413 (c.30:4D-6) is amended to read as follows:

����� 6.� a.� Subject to the 
requirements of Title XIX of the federal Social Security Act, the limitations 
imposed by this act and by the rules and regulations promulgated pursuant 
thereto, the department shall provide medical assistance to qualified applicants, 
including authorized services within each of the following classifications:

���� (1)� Inpatient hospital 
services

���� (2)� Outpatient hospital 
services;

���� (3)� Other laboratory and 
X-ray services;

���� (4)� (a)� Skilled nursing or 
intermediate care facility services;

���� (b)� Early and periodic 
screening and diagnosis of individuals who are eligible under the program and 
are under age 21, to ascertain their physical or mental health status and the 
health care, treatment, and other measures to correct or ameliorate defects and 
chronic conditions discovered thereby, as may be provided in regulation of the 
Secretary of the federal Department of Health and Human Services and approved 
by the commissioner;

���� (5)� Physician's services 
furnished in the office, the patient's home, a hospital, a skilled nursing, or 
intermediate care facility or elsewhere.

���� As used in this subsection, 
"laboratory and X-ray services" includes HIV drug resistance testing, 
including, but not limited to, genotype assays that have been cleared or 
approved by the federal Food and Drug Administration, laboratory developed 
genotype assays, phenotype assays, and other assays using phenotype prediction 
with genotype comparison, for persons diagnosed with HIV infection or AIDS.

���� b.� Subject to the limitations 
imposed by federal law, by this act, and by the rules and regulations 
promulgated pursuant thereto, the medical assistance program may be expanded to 
include authorized services within each of the following classifications:

���� (1)� Medical care not included 
in subsection a.(5) above, or any other type of remedial care recognized under 
State law, furnished by licensed practitioners within the scope of their 
practice, as defined by State law;

���� (2)� Home health care 
services;

���� (3)� Clinic services;

���� (4)� Dental services;

���� (5)� Physical therapy and 
related services;

���� (6)� Prescribed drugs, 
dentures, and prosthetic devices; and eyeglasses prescribed by a physician 
skilled in diseases of the eye or by an optometrist, whichever the individual 
may select;

���� (7)� Optometric services;

���� (8)� Podiatric services;

���� (9)� Chiropractic services;

���� (10)� Psychological services;

���� (11)� Inpatient psychiatric 
hospital services for individuals under 21 years of age, or under age 22 if 
they are receiving such services immediately before attaining age 21;

���� (12)� Other diagnostic, 
screening, preventative, and rehabilitative services, and other remedial care;

���� (13)� Inpatient hospital 
services, nursing facility services, and immediate care facility services for 
individuals 65 years of age or over in an institution for mental diseases;

���� (14)� Intermediate care 
facility services;

���� (15)� Transportation services;

���� (16)� Services in connection 
with the inpatient or outpatient treatment or care of substance use disorder, 
when the treatment is prescribed by a physician and provided in a licensed 
hospital or in a narcotic and substance use disorder treatment center approved 
by the Department of Health pursuant to P.L.1970, c.334 (C.26:2G-21 et. seq.) 
and whose staff includes a medical director, and limited those services 
eligible for federal financial participation under Title XIX of the federal 
Social Security Act;

���� (17)� Any other medical care 
and any other type of remedial care recognized under State law, specified by 
the Secretary of the federal Department of Health and Human Services, and 
approved by the commissioner;

���� (18)� Comprehensive maternity 
care, which may include: the basic number of prenatal and postpartum visits 
recommended by the American College of Obstetrics and Gynecology; additional 
prenatal and postpartum visits that are medically necessary; necessary laboratory, 
nutritional assessment and counseling, health education, personal counseling, 
managed care, outreach, and follow-up servi