Vitale Bill to Streamline Medicaid, NJ FamilyCare Eligibility & Intake Process Advances

Senator Joseph F. Vitale, D-Middlesex, speaks to reporters after a news conference on the Statehouse steps on his efforts to limit charitable immunity in cases when the charity acts negligently in protecting children from sexual abuse.

TRENTON A bill sponsored by Senate Health, Social Services and Senior Citizens Committee Chair Joseph F. Vitale that would provide for an improved system for eligibility determination for the Medicaid and NJ FamilyCare programs was approved by the Senate Budget and Appropriations Committee today.

Under the bill, the Commissioner of Human Services, in consultation with the Office of Information Technology, 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 benefits applications under the Medicaid program.

“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 places a burden on the state, the dedicated workers handling the intake, and our residents who need health insurance but find themselves losing coverage because of gaps in the system,” said Senator Vitale (D-Middlesex).  “This bill will streamline the entire process, placing more effective tools in the hands of the processors and putting the focus on the wellbeing and satisfaction of applicants.”

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 relevant applications data among state and county agencies and contractors; and
  • 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.  The results of the performance evaluations would be published annually on the Department of Human Services website.

The bill would call for the commissioner to establish a system of rewards and penalties to serve as incentives for improved performance and extended hours at county welfare agencies.  It would also require the commissioner to designate an ombudsperson to receive, review and make recommendations on complaints about the eligibility application process.

The bill was released from committee with a vote of 12-0.