The Department of Human Services (DHS), Division of Medical Assistance and Health Services (DMAHS), has awarded a one-time grant of $75,000 to five Provider Agencies to participate in the NJ FamilyCare Outreach and Enrollment Project 100% Insured For Sure!. The Project will run from October 1, 2018 through September 30, 2019 for former and/or current CMS FFM Navigator Grantees serving New Jersey to provide outreach and enrollment assistance for uninsured New Jersey residents.
Managed Care Organizations are responsible for all acute care admissions to any hospital for all managed care NJ FamilyCare enrollees, regardless of age. This change includes both general acute care hospitals and specialty care psychiatric hospitals.
Effective October 1, 2018, NJ FamilyCare managed health care benefit plan changed for Division of Developmentally Disabled (DDD) managed care enrollees, and beneficiaries enrolled in Managed Long Term Services and Supports (MLTSS) or Fully Integrated Dual Eligible Special Needs Plans (FIDE SNP). The new benefit plan will include all mental health and substance use disorder treatment benefits, with listed exceptions, in order to align the populations' behavioral benefits with their other managed care provided services.
Effective October 1, 2018, Long Term Residential Services are added to the continuum of care as a Medicaid covered service for individuals 18 and over. New Jersey will also cover expenditures for services provided in an Institution for Mental Disease (IMD) for Long Term Residential Treatment Services.
The Department of Human Services Division of Medical Assistance and Health Services launches NJ FamilyCare Data Dashboards.
Effective July 1, Short-Term Residential and Residential Withdrawal Management Services are extended to individuals between 21 and 64 years of age when provided by facilities that meet the definition of an Institution for Mental Disease (IMD).
Authorizes New Jersey to expand the OUD/SUD benefit package to combat prescription drug abuse and opioid use disorders, and provide treatment services, including withdrawal management services in residential treatment facilities that meet the definition of an Institution for Mental Disease (IMD).
Program of All-inclusive Care for the Elderly (PACE) located in Atlantic County.
The New Jersey 1115 Comprehensive Medicaid Waiver Demonstration is a Research and Demonstration waiver granted by CMS. The Waiver gives New Jersey the authority to operate most of the NJ FamilyCare program, and the flexibility to design and improve programs using innovative ideas that are typically not allowed under Medicaid and CHIP rules.
Medicaid fee-for-service (FFS) substance use disorders (SUD) benefits were added for Plan A title 19 recipients as of July 2016.
Physician fee increase for primary care, postpartum, preventative services for fee-for-service claims begins. Managed care physician fee increases program begins.
The largest rate increase to the behavioral health provider community in more than a decade. $127 million to be invested in enhanced rates for behavioral health professionals who provide services to NJ FamilyCare beneficiaries.
Program of All-inclusive Care for the Elderly (PACE) located in Monmouth County.
A demonstration that provides an opportunity to explore innovative system re-design. Three Accountable Care Organizations were certified: Camden Coalition of Healthcare Providers, Trenton Health Team and Healthy Greater Newark.
The Interim Managing Entity (IME) provides a coordinated point of entry for those seeking treatment for substance use disorder. The IME is managed by Rutgers University Behavioral Health Care.
New Jersey became the first state to receive authority to connect to the Federal Data Services Hub using a cloud service.
Aetna Better Health of New Jersey is awarded a contract to participate in NJ FamilyCare.
A financial eligibility policy which allows an individual to place assets in a Trust to establish or maintain Medicaid eligibility. Certain conditions must be met and are subject to the approval of, and monitoring by, the agency that determines eligibility.
The assets of HealthFirst were acquired by WellCare.
Managed Long Term Services and Supports (MLTSS) integrated into Managed Care contract. All services for waiver recipients and new nursing facility residents provided under Managed Care. Self-directed services provided under Managed Care.
NJ is the first state to use web services to automate Modified Adjusted Gross Income (MAGI) eligibility determinations.
WellCare begins operations in Medicaid managed care in Essex, Hudson, Middlesex, Passaic and Union counties.
NJ Family Care parents (Title XIX) and Childless Adults up to 138% of the population covered under the Affordable Care Act. Medicaid FFS SUD benefits were added for the ACA expansion group as of January 2014.