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Weinberg, Cruz-Perez Bill Setting Reimbursement Rate Floor for In-Home Care By Medicaid Insurance Providers Now Law

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 – is now law. 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 law (S-1018) requires 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. Establishing a rate floor is the right thing to do to protect the care provided to our most vulnerable.”

The law requires that the minimum hourly rate for personal care services be no less than the established state Medicaid fee-for-service rate.

It will take effect on July 1, 2018 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 33-0 Thursday. The Assembly approved it 68-0 in July. The governor signed it today.