Senate Passes Vitale, Madden Bill to Improve Medicaid, NJ FamilyCare Eligibility & Intake Process

TRENTON – A bill sponsored by Senator Joseph F. Vitale and Senator Fred Madden that would provide for an improved system for eligibility determination for the Medicaid and NJ FamilyCare programs was cleared by the Senate today.

“The system that is in place now is a patchwork of county, state and federal social services with electronic processes that vary in their timing and accuracy rates. It is inefficient for state and the applicants applying for health coverage,” said Senator Vitale (D-Middlesex). “This bill would streamline the entire process, placing more effective tools in the hands of the processors and improving the satisfaction of applicants.”

Under the bill, the Commissioner of Human Services would develop an information technology platform for use by the state, county welfare agencies, and state contractor for the purpose of intake, processing and tracking of applications for benefits under the Medicaid program.

“Agencies fielding applications for healthcare programs need access to technology that will make their operations as efficient as possible,” said Senator Madden (D-Camden/Gloucester). “This bill would improve the application process making it faster and more user-friendly.”

The bill, S-499, would:

• simplify the applications and eligibility determination processes to make it easier for both applicants and staff

• standardize application of eligibility policy across the various agencies involved

• allow for real-time tracking of application status

• allow the rapid exchange of data relevant to applications among state and county agencies and contractors

• provide a platform to expand the system to encompass other social service program applications and eligibility determinations as the technology permits

The bill would also require the commissioner to establish a system to evaluate the performance of all entities responsible for intake and processing of applications for the Medicaid and NJ FamilyCare programs, including all county welfare agencies and the state’s contracted health benefits coordinator. A system of rewards and penalties providing incentives for performance would be implemented as well. The results of the performance evaluations would be published annually on the Department of Human Services website.

The bill was released from the Senate by a vote of 38-0.