Legislation sponsored by Senator Holly Schepisi that would establish minimum Medicaid reimbursement rates for brain injury services was approved by the New Jersey Senate.

Legislation sponsored by Sen. Holly Schepisi that would establish minimum Medicaid reimbursement rates for brain injury services was approved by the New Jersey Senate. (©iStock)

“Unlike other Medicaid community-based services, reimbursement rates for brain injury services have remained static in recent years despite growing costs. This threatens the ability of providers to meet the complex needs of individuals with brain injuries and provide services within a safe and fulfilling community environment,” said Schepisi (R-39). “And yet, despite the similar model of care, reimbursement rates for services provided to Medicaid beneficiaries with intellectual and developmental disabilities have not only increased, but have actually restructured to account for inflationary trends. My legislation will align brain injury service rates with intellectual and developmental disabilities service rates to ensure that people with brain injuries can continue to thrive and reach their optimal recoveries in community settings.”

The legislation, S-2049/A-3110, establishes minimum Medicaid reimbursement rates for brain injury services—including both traumatic brain injuries and non-traumatic brain injuries.

“Traumatic brain injury” means an injury to the brain caused by a blow or jolt to the head or neuro-trauma that disrupts the normal brain function. “Non-traumatic brain injury” means an injury to the brain caused by internal factors, such as stroke, aneurysm, tumor, or infectious disease.

Under Schepisi’s bill, brain injury services include community-based services, residential services, day care services, and home care services whether the services are provided through the Medicaid fee-for-service delivery system or the managed care delivery system.