Insights & Resources

April 11, 2023 | Alerts

CMS Approves New Jersey FamilyCare’s Comprehensive 1115 Demonstration

CMS Approves New Jersey FamilyCare’s Comprehensive 1115 Demonstration

On March 30, 2023, the Centers for Medicaid and Medicare Services (“CMS“) approved New Jersey FamilyCare’s Comprehensive 1115 Demonstration renewal. The renewal expands, amends and implements various projects and programs relating to Housing, Behavioral and Physical Health, and Worker Training that will enhance health care coverage, access and services to New Jersey FamilyCare members, which include Medicaid and CHIP beneficiaries.

The Comprehensive 1115 Demonstration provides New Jersey with federal authority to operate large parts of the NJ FamilyCare program, and will include several new programs, for example:

  • Creation of an incentive based-payment program for Medicaid behavioral health providers to implement health information technology (“HIT“) functionality to support integrated and high quality care;
  • Formation of an Autism Adjunct Services Pilot that will support and provide children living with autism rehabilitative and therapeutic services, such as aquatic, recreational and music therapies;
  • Establishment of a Community Health Worker Pilot that will focus on overcoming health disparities within local communities by providing care coordination services and directly providing preventive or related services; and
  • A new multifaceted, integrated housing strategy for Medicaid beneficiaries that incorporates coverage for additional targeted services, and coordination across state and community resources involved in the provision of health and housing services, including, enhancements to the Managed Long Term Services and Supports program.

The plan includes additional programs that benefit FamilyCare members and providers, and enhancements to existing programs.

The renewal is effective as of April 1, 2023 through June 30, 2028 and is subject to limitations and other special terms and conditions.