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Weinberg, Cruz-Perez Bill Setting Reimbursement Rate Floor for In-Home Care By Medicaid Insurance Providers Goes to Governor

Senator Weinberg


Rate Cuts Threaten Quality & Availability of In-Home Care Services


TRENTON – Legislation sponsored by Senate Majority Leader Loretta Weinberg and Senator Nilsa Cruz-Perez to halt cuts to reimbursement rates by Medicaid Managed Care Organizations for personal care assistant services – a Medicaid benefit utilized by nearly 40,000 patients in New Jersey – received final approval today by the Senate. Personal Care Assistants help residents with basic tasks, such as bathing, dressing and eating, and allows those with severe health conditions to continue living at home and receiving needed care.

The bill (S-1018) would require that reimbursement rates for personal care services funded through Medicaid fee-for-service delivery or a Medicaid Managed Care organization be no less than the established state Medicaid fee-for-service rate – currently set at $18.00 per hour – with adjustments in the future.

“There has been a trend towards reducing the rates for personal care assistant services. It is essentially a race to the bottom to see who can pay the lowest reimbursement rates and get the biggest bang for their buck,” said Senator Weinberg (D-Bergen). “Cutting rates puts more pressure on health care providers – and means they aren’t able to offer their employees the compensation they deserve and the increase in pay they need to keep experienced health care workers on the job. This threatens both the quality and the availability of care for those who need it.”

“At this point, we are practically asking these dedicated individuals to volunteer their services, and to sacrifice the wellness of their own families as they work to address the needs of their patients,” said Senator Cruz-Perez (D-Camden/Gloucester). “If the providers cannot offer a competitive salary, they will stop being able to attract the caring, dedicated and highly in-demand caregivers that New Jersey residents deserve, no matter how big their hearts, how great their passion for helping others. Establishing a rate floor is the right thing to do to protect the care provided to our most vulnerable.”

The bill would require that the minimum hourly rate for personal care services be increased every five years based in direct proportion to the rise or fall in the Consumer Price Indices average for all urban wage earners for the New York metropolitan and the Philadelphia metropolitan regions as reported by the Bureau of Labor Statistics of the United States Department of Labor during the last full calendar year preceding the date upon which the adjustment is made.

The bill would take effect immediately and apply to services provided on or after the effective date of this act and to any Medicaid managed care contract executed or renewed on or after the effective date of this act.

The Senate approved the legislation by a vote of 39-0. The Assembly approved it 64-10-2. It now goes to the governor.