reglab/statecodes huggingface dataset:
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.42 - Hospital not claiming deduction for bad debt eligible for reimbursement for charity care

26:2H-18.42. Hospital not claiming deduction for bad debt eligible for reimbursement for charity care
20. Notwithstanding the provisions of section 6 of P.L.1991, c.187 (C.26:2H-18.29) to the contrary, a hospital that does not claim any deduction for bad debt for the purpose of the department's determination of that hospital's uncompensated care factor pursuant to N.J.A.C.8:31B-4.39, is eligible for full reimbursement for charity care, as provided pursuant to N.J.A.C.8:31B-4.37, for all eligible patients regardless of a patient's state of residence; except that this section shall not apply in the case of a patient who is not a resident of the United States.
L.1991,c.187,s.20; amended 1992,c.68,s.2; per s.86 as amended by 1992, c.160, s.27, expired December 31, 1992.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.43 - Compensation provided for cost of advanced life support services

26:2H-18.43. Compensation provided for cost of advanced life support services
a. The cost of advanced life support services provided pursuant to P.L.1984, c.146 (C.26:2K-7 et seq.) to medically indigent persons incurred through a hospital's provision of advanced life support services shall be compensated pursuant to this act. The commission shall, by regulation, establish a schedule of reimbursement rates for advanced life support services. Reimbursement for mobile intensive care unit uncompensated care shall only include those uninsured patients who are classified as charity care pursuant to regulations promulgated by the commissioner. Reimbursement shall exclude bad debt, the difference in a contractual allowance, or any medical denials for a service.
b. The cost of advanced life support services provided by the University of Medicine and Dentistry of New Jersey University Hospital to uninsured patients who are classified as charity care shall be uncompensated care, except that such uncompensated care shall be exempt from any reimbursement limitations for uncompensated care that apply to University Hospital. Reimbursement for advanced life support services uncompensated care for University Hospital shall not be paid from the fund, but shall be paid through the reimbursement rates of University Hospital as established by the commission.
L.1991,c.187,s.21; per s.86 as amended by 1992, c.160, s.27, expired December 31, 1992.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.44 - Determination of eligibility for uncompensated care not applicable to patient found indigent

26:2H-18.44. Determination of eligibility for uncompensated care not applicable to patient found indigent
For all periods for which an audit for reimbursement for uncompensated care through the Uncompensated Care Trust Fund established pursuant to P.L.1989, c.1 (C.26:2H-18.4 et seq.) shall be conducted, the requirements regarding the determination of eligibility for charity care pursuant to sections 9 and 10 of P.L.1989, c.1 (C.26:2H-18.12 and 18.13) shall not apply to a patient who is investigated by a county adjuster and found to be indigent by a court of competent jurisdiction pursuant to the provisions of chapter 4 of Title 30 of the Revised Statutes. A patient so found shall qualify for charity care.
L.1991,c.187,s.22; per s.86 as amended by 1992, c.160, s.27, expired December 31, 1992.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.45 - Pilot program to create partnership between urban hospitals and community health centers

26:2H-18.45. Pilot program to create partnership between urban hospitals and community health centers
a. The commissioner shall establish a pilot program to create a partnership between urban hospitals with high uncompensated care costs and community health centers in order to provide primary health care in the most appropriate community setting. The commissioner shall select one hospital with high uncompensated care costs in the northern, central and southern regions of the State, respectively, to participate in the program. The commissioner shall establish the program by September 1, 1991.
b. Each hospital selected to participate in the program shall establish a formal agreement with a community health center located near the hospital, in which the hospital agrees to refer emergency room patients who are not in need of emergency care, but require primary care, to the community health center for the needed medical services. The agreement shall stipulate that if the patient who is referred to the community health center cannot afford to pay for the health care services provided at the center and qualifies for charity care pursuant to requirements established by the commissioner, the center shall submit the bill to the referring hospital and the hospital shall include the amount of the bill in its uncompensated care costs. The hospital shall reimburse the center for the approved charity care provided pursuant to this pilot program. The agreement shall also stipulate that the community health center shall operate at hours that reflect the needs of the community and shall provide an emergency contact during nonoperating hours.
L.1991,c.187,s.23; per s.86 as amended by 1992, c.160, s.27, expired December 31, 1992.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.46 - Report on status of fund

26:2H-18.46. Report on status of fund
24. The commissioner shall report to the Governor, the presiding officers of the Senate and the General Assembly, and the chairmen of the Senate and the General Assembly Health and Human Services Committees, six and 11 months after the effective date of this act and annually thereafter, by June 30 of each year, on the status of the fund.
a. The commissioner shall include in the first report a summary of the findings of the 1990 annual audit of each hospital's uncompensated care conducted pursuant to section 12 of P.L.1991, c.187 (C.26:2H-18.34). The summary shall include the percentage of uncompensated care for each hospital that is classified as charity care and as bad debt, respectively. The report shall also include a compilation of the information collected pursuant to section 13 of P.L.1991, c.187 (C.26:2H-18.35).
b. The commissioner shall include in the second report a compilation of the information collected pursuant to section 13 of P.L.1991, c.187 (C.26:2H-18.35) and provided by the Department of the Treasury pursuant to section 14 of P.L.1991, c.187 (C.26:2H-18.36).
L.1991,c.187,s.24; amended 1992,c.25,s.3; per s.86 as amended by 1992, c.160, s.27, expired December 31, 1992.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.47 - "Health Care Cost Reduction Fund" established

26:2H-18.47. "Health Care Cost Reduction Fund" established
a. There is established in the Department of Health a special fund to be known as the "Health Care Cost Reduction Fund."
The monies in the Health Care Cost Reduction Fund are hereby appropriated for the purposes and in amounts not to exceed the amounts specified in this subsection:
(1) Local health planning - $3 million per year;
(2) Demographic study of hospital patients whose accounts are classified as bad debts - $50,000;
(3) Primary Care Physician and Dentist Loan Redemption Program - $1 million per year;
(4) Provision of funds to community health centers funded under sections 329 or 330 of the "Public Health Service Act," (42 U.S.C. s. 254b, 254c) or which have been designated by the Health Resources and Services Administration in the United States Public Health Service as a Federally Qualified Health Center, to enable these centers to expand their hours of operation to evenings and weekends, and to enhance and advertise their primary health care services as an alternative to hospital emergency rooms - $10 million per year;
(5) Expansion of eligibility for the Medicaid program to 185% of the poverty level for pregnant women and infants up to one year of age;
(6) Establishment of a "HealthStart Plus" program for pregnant women and infants up to age one whose income is between 185% and 300% of the poverty level - $8 million per year;
(7) Establishment of the "Competitive Initiatives Fund" to strengthen relationships between hospitals and community health centers - $6 million per year; and
(8) Other reform measures established by law which are designed to contain the cost of uncompensated care.
The department shall maintain a separate account for each of the reform measures funded by the Health Care Cost Reduction Fund.
b. Notwithstanding any law to the contrary, each hospital whose rates are established by the commission pursuant to P.L.1978, c.83 (C.26:2H-1 et al.) shall pay .53% of its approved revenue base for 1991 to the Department of Health for deposit in the Health Care Cost Reduction Fund. The hospital shall make monthly payments to the department for a period of 24 months beginning on the first month following the date of enactment of this act, except that the total amount paid into the Health Care Cost Reduction Fund plus interest shall not exceed $40 million per year. The commissioner shall determine the manner in which the payments shall be made.
c. The commissioner shall report to the Senate Institutions, Health and Welfare Committee and the General Assembly Health and Human Services Committee quarterly on the status of the Health Care Cost Reduction Fund. The report shall specify the amount of revenues received by the fund and the specific expenditures made, and proposed to be made, from the fund.
L.1991,c.187,s.25.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.48 - Transfer of employees, appropriations etc. to the "New Jersey Health Care Trust Fund"

26:2H-18.48. Transfer of employees, appropriations etc. to the "New Jersey Health Care Trust Fund"
The employees, appropriations and other moneys, files, books, papers, records, equipment and other property of the "New Jersey Uncompensated Care Trust Fund" and the "Uncompensated Care Trust Fund Advisory Committee," established pursuant to P.L.1986, c.204, and continued pursuant to P.L.1989, c.1 (C.26:2H-18.4 et seq.), which law expired on December 31, 1990, are transferred, pursuant to the "State Agency Transfer Act," P.L.1971, c.375 (C.52:14D-1 et seq.) to the "New Jersey Health Care Trust Fund" established pursuant to this act.
L.1991,c.187,s.26; per s.86 as amended by 1992, c.160, s.27, expired December 31, 1992.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.51 - Findings, declarations

26:2H-18.51. Findings, declarations
1. The Legislature finds and declares that:
a. It is of paramount public interest for the State to take all necessary and appropriate actions to ensure access to and the provision of high quality and cost-effective hospital care to its citizens.
b. The highly regulated system under which acute care hospitals have been forced to operate in New Jersey since the enactment of P.L.1978, c.83 was intended to control health care costs and promote the efficient and effective delivery of health care; however, because health care costs have continued to increase at an alarming rate, the State clearly needs to eliminate the current Diagnosis Related Group (DRG) rate setting methodology it initiated in 1980 and move in the direction of a deregulated hospital reimbursement system which will provide hospitals with a truly competitive market environment and strong incentives to offer only those services which meet the demands of health care purchasers and consumers.
c. Access to quality health care shall not be denied to residents of this State because of their inability to pay for the care; there are many residents of this State who cannot afford to pay for needed hospital care and in order to ensure that these persons have equal access to hospital care, it is necessary to provide disproportionate share hospitals with a charity care subsidy supported by a broad-based funding mechanism.
d. In order to provide financial support to those hospitals with a disproportionately large number of Medicare patients, it is also necessary to provide for a Medicare hospital subsidy, also supported by a broad-based funding mechanism, as a temporary means to distribute payments to disproportionate share hospitals which experience a significant shortfall in their revenues due to the difference between the hospital's actual rates for health care services and the rates paid by the Medicare program for those services.
e. There is a need to continue this State's current system of providing disproportionate share payments to hospitals in the State, and in order to ensure continuity of these payments, this act establishes the Health Care Subsidy Fund.
f. In order to ensure a smooth transition to a new, deregulated hospital reimbursement system that significantly alters the State's policy towards the delivery of health care, it is necessary to establish an independent commission which is not tied to past practices of hospital rate regulation.
L.1992,c.160,s.1.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.52 - Definitions relative to provision of health care services to low income persons.

26:2H-18.52 Definitions relative to provision of health care services to low income persons.
2. As used in sections 1 through 17 of P.L.1992, c.160 (C.26:2H-18.51 through 26:2H-18.67), sections 12 through 15 of P.L.1995, c.133 (C.26:2H-18.59a through C.26:2H-18.59d), sections 7 through 12 of P.L.1996, c.28 (C.26:2H-18.59e et al.) and sections 6, 8, 10 and 11 of P.L.1997, c.263 (C.26:2H-18.58e, C.26:2H-18.58f, C.26:2H-18.58d and C.26:2H-18.59h):
"Administrator" means the administrator of the Health Care Subsidy Fund appointed by the commissioner.
"Charity care" means care provided at disproportionate share hospitals that may be eligible for a charity care subsidy pursuant to this act.
"Charity care subsidy" means the component of the disproportionate share payment that is attributable to care provided at a disproportionate share hospital to persons unable to pay for that care, as provided in this act.
"Commission" means the New Jersey Essential Health Services Commission established pursuant to section 4 of this act.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Disproportionate share hospital" means a hospital designated by the Commissioner of Human Services pursuant to Pub.L.89-97 (42 U.S.C. s.1396a et seq.) and Pub.L.102-234.
"Disproportionate share payment" means those payments made by the Division of Medical Assistance and Health Services in the Department of Human Services to hospitals defined as disproportionate share hospitals by the Commissioner of Human Services in accordance with federal laws and regulations applicable to hospitals serving a disproportionate number of low income patients.
"Fund" means the Health Care Subsidy Fund established pursuant to section 8 of this act.
"Hospital" means an acute care hospital licensed by the Department of Health pursuant to P.L.1971, c.136 (C.26:2H-1 et al.).
"Medicaid" means the New Jersey Medical Assistance and Health Services Program in the Department of Human Services established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
"Medicare" means the program established pursuant to Pub.L.89-97 (42 U.S.C. s.1395 et seq.).
L.1992, c.160, s.2; amended 1995, c.133, s.1 1996, c.28, s.1; 1997, c.263, s.1; 2012, c.17, s.220.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.54a - New Jersey Essential Health Services Commission abolished

26:2H-18.54a New Jersey Essential Health Services Commission abolished
16. a. The New Jersey Essential Health Services Commission created pursuant to P.L.1992, c.160 (C.26:2H-18.51 et al.) is abolished and all of its functions, powers and duties, except as herein otherwise provided, are transferred to the Department of Health on the effective date of this act.
b. Whenever, in any rule, regulation, order, contract, document, judicial or administrative proceeding or otherwise, reference is made to the New Jersey Essential Health Services Commission or the officers thereof, the same shall mean and refer to the Department of Health or the officers thereof.
c. This transfer shall be subject to the provisions of the "State Agency Transfer Act," P.L.1971, c.375 (C.52:14D-1 et seq.).
L.1995,c.133,s.16.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.55 - Duties of commissioner

26:2H-18.55. Duties of commissioner
5. The commissioner shall:
a. Administer the fund and establish a mechanism to allocate monies received from the Commissioner of Labor pursuant to section 29 of P.L.1992, c.160 (C.43:21-7b) to the appropriate accounts in the fund as specified in this act;
b. Establish eligibility determination and claims pricing systems for the charity care component of the disproportionate share subsidy, including the development of uniform forms for determining eligibility and submitting claims. The commissioner may contract with a private claims administrator or processor for the purpose of processing hospital claims for charity care pursuant to this act;
c. Establish and implement by January 1, 1997, a schedule of payments for reimbursement of the charity care component of the disproportionate share payment for services provided to emergency room patients who do not require those services on an emergency basis;
d. In cooperation with the Departments of Insurance and Human Services, develop and provide for the implementation of the Health Access New Jersey program pursuant to section 15 of P.L.1992, c.160 (C.26:2H-18.65);
e. Study and, if feasible, establish hospital cost and outcome reports to provide assistance to consumers of health care in this State in making prudent health care choices;
f. Compile demographic information on recipients of, and types of services paid for by, the charity care component of the disproportionate share payment and periodically report a summary of this information to the Governor and Legislature. The demographic information shall include, at a minimum, the recipient's age, sex, marital status, employment status, type of health insurance coverage, if any, and if the recipient is a child under 18 years of age who does not have health insurance coverage or a married person who does not have health insurance coverage, whether the child's parent or the married person's spouse, as the case may be, has health insurance;
g. (Deleted by amendment, P.L.1995, c.133.)
h. (Deleted by amendment, P.L.1995, c.133.)
i. (Deleted by amendment, P.L.1995, c.133.)
j. (Deleted by amendment, P.L.1995, c.133.)
k. (Deleted by amendment, P.L.1995, c.133.)
l. Encourage the use of centralized data storage and transmission technology that utilizes personal and image identification systems as well as identity verification technology for the purposes of enabling a hospital to access medical history, insurance information and other personal information, as appropriate;
m. (Deleted by amendment, P.L.1995, c.133.)
n. (Deleted by amendment, P.L.1995, c.133.)
o. Take such other actions as the commissioner deems necessary and appropriate to carry out the provisions of P.L.1992, c.160 (C.26:2H-18.51 et al.); and
p. Report annually, by December 1 of each year, to the Governor and the Senate and General Assembly standing reference committees on budget and appropriations on the status of the fund.
L.1992,c.160,s.5; amended 1995, c.133, s.2; 1996,c.28,s.2..
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.55a - Compilation of information relative to employed recipients of charity care.

26:2H-18.55a Compilation of information relative to employed recipients of charity care.
2. a. The Commissioner of Health shall compile, to the extent data are available, the following information about recipients of charity care who are employed:
(1) the employer's name and address;
(2) the number of recipients of charity care who are employed by the employer; and
(3) the cost to the State of providing charity care for the employer's employees and their dependents.
b. In order to compile the information required pursuant to this section, the commissioner may require hospitals and other health care facilities to submit such information as may be necessary for this purpose.
c. The commissioner may include comparable information about recipients of other public health care coverage programs, and other information as the commissioner deems appropriate regarding employer-based coverage for persons covered under public insurance programs.
d. The information compiled by the commissioner shall not include the name of any charity care recipient or any family member of a recipient.
e. The commissioner shall provide the information required pursuant to this section to the Commissioner of Human Services for inclusion in the annual report on Access to Employer-Based Health Insurance, as provided in section 1 of P.L.2006, c.87 (C.30:4J-17).
L.2006, c.87, s.2; amended 2012, c.17, s.221.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.58a - Funding of community-based drug abuse treatment programs.

26:2H-18.58a. Funding of community-based drug abuse treatment programs.
4. The Commissioner of Health shall transfer to the Division of Mental Health and Addiction Services in the Department of Human Services from the Health Care Subsidy Fund, $10 million in Fiscal Year 1997 and $20 million in Fiscal Year 1998 and each fiscal year thereafter, or such sums as are made available pursuant to section 5 of P.L.1996, c.29 (C.52:18A-2a), whichever amount is less, according to a schedule to be determined by the Commissioner of Health, to fund community-based substance use disorder treatment programs in the following order of priority: residential, inpatient, intensive day, and outpatient treatment.
L.1996, c.29, s.4; amended 2023, c.177, s.84.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.58b - Health Care Subsidy Fund payer of last resort; exemptions

26:2H-18.58b. Health Care Subsidy Fund payer of last resort; exemptions
10. With the exception of the Catastrophic Illness in Children Relief Fund, established pursuant to P.L.1987, c.370 (C.26:2-148 et seq.) and the Victims of Crime Compensation Board established pursuant to section 3 of P.L.1971, c.317 (C.52:4B-3), the Health Care Subsidy Fund is the payer of last resort for persons who otherwise qualify for charity care or managed health care services pursuant to P.L.1992, c.160 (C.26:2H-18.51 et al.) and P.L.1996, c.28. A hospital or other health care provider shall not submit a claim for charity care or managed health care services reimbursement on behalf of any individual otherwise eligible for charity care or managed health care services for whom the hospital or other health care provider is eligible to receive reimbursement under any State or federal program not specifically exempted in this section or any other third party payer.
L.1996,c.28,s.10.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.58c - Funding of Health Care Subsidy Fund.

26:2H-18.58c Funding of Health Care Subsidy Fund.
11. a. The Health Care Subsidy Fund shall be funded with $15 million in General Fund revenues in calendar year 1996 and $41 million in General Fund revenues in calendar year 1997 and $42.9 million in General Fund revenues for the period January 1, 1998 through June 30, 1998.
b. The Health Care Subsidy Fund shall be supported with revenues derived from efficiencies achieved by State use of an electronic data interchange system for health care claims and related information, in amounts necessary to provide funding for the provision of charity care pursuant to P.L.1992, c.160 (C.26:2H-18.51 et al.).
L.1996,c.28,s.11; amended 1997, c.263, s.3; 1998, c.37, s.4.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.58d - Appropriations to Health Care Subsidy Fund.

26:2H-18.58d Appropriations to Health Care Subsidy Fund.
10. In fiscal year 1999 and each year thereafter, the Governor shall recommend and the Legislature shall appropriate to the Health Care Subsidy Fund to carry out the purposes of P.L.1992, c.160 (C.26:2H-18.51 et al.), such funds from the General Fund which, when combined with other resources deposited in the Health Care Subsidy Fund, shall be sufficient to carry out the purposes of that act.
L.1997,c.263,s.10.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.58e - Transfer of funds to Hospital Relief Fund.

26:2H-18.58e Transfer of funds to Hospital Relief Fund.
6. a. The Commissioner of Health shall transfer to the Hospital Health Care Subsidy account, known as the Hospital Relief Fund, in the Division of Medical Assistance and Health Services in the Department of Human Services from the Health Care Subsidy Fund, $50.75 million in fiscal year 1998 and $101.5 million each fiscal year thereafter, according to a schedule to be determined by the Commissioner of Health in consultation with the Commissioner of Human Services. These funds shall be distributed to eligible disproportionate share hospitals according to a methodology adopted by the Commissioner of Human Services pursuant to N.J.A.C.10:52-8.2, using hospital expenditure data for the most recent calendar year available for reimbursements from these funds.
b. In fiscal year 1998 and each fiscal year thereafter, the Governor shall recommend and the Legislature shall appropriate to the Hospital Health Care Subsidy account for distribution to disproportionate share hospitals which are eligible for reimbursement pursuant to subsection a. of this section, those federal funds received in connection with the provision of hospital reimbursements from that account.
L.1997, c.263, s.6; amended 2012, c.17, s.224.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.58f - Transfer of funds to Division of Medical Assistance and Health Services.

26:2H-18.58f Transfer of funds to Division of Medical Assistance and Health Services.
8. a. The Commissioner of Health shall transfer to the Division of Medical Assistance and Health Services in the Department of Human Services from the Health Care Subsidy Fund, $23.8 million in fiscal year 1998, $47.6 million in fiscal year 1999, and an amount in each succeeding fiscal year that is necessary to obtain the maximum amount of federal funds to which the State is entitled in order to provide children's health care coverage in the NJ FamilyCare Program pursuant to P.L.2005, c.156 (C.30:4J-8 et al.), according to a schedule to be determined by the Commissioner of Health in consultation with the Commissioner of Human Services. These funds shall be expended to provide children's health care coverage in the NJ FamilyCare Program pursuant to P.L.2005, c.156.
b. In fiscal year 1999 and each fiscal year thereafter, the Governor shall recommend and the Legislature shall appropriate to the Division of Medical Assistance and Health Services for the purposes of subsection a. of this section, those federal funds received in connection with the provision of children's health care coverage in the NJ FamilyCare Program pursuant to P.L.2005, c.156.
L.1997, c.263, s.8; amended 2012, c.17, s.225.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.58h - Annual deposit into Health Care Subsidy Fund from revenue from sale of alcoholic beverages.

26:2H-18.58h Annual deposit into Health Care Subsidy Fund from revenue from sale of alcoholic beverages.
2. Commencing with fiscal years beginning on and after July 1, 2009, there shall be deposited annually in the Health Care Subsidy Fund established pursuant to section 8 of P.L.1992, c.160 (C.26:2H-18.58), the sum of $22,000,000 from the revenue collected annually pursuant to the "Alcoholic Beverage Tax Law," R.S.54:41-1 et seq.
L.2009, c.71, s.2.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.58i - Deposits into Health Care Subsidy Fund from revenue collected from taxation of certain insurance policies.

26:2H-18.58i Deposits into Health Care Subsidy Fund from revenue collected from taxation of certain insurance policies.
7. During the fiscal year beginning on July 1, 2009, there shall be deposited in the Health Care Subsidy Fund established pursuant to section 8 of P.L.1992, c.160 (C.26:2H-18.58): the sum of $19.5 million from the revenue collected from the taxation of group accident and health insurance policies pursuant to subsection (b) of section 2 of P.L.1945, c.132 (C.54:18A-2) and subsection (b) of section 3 of P.L.1945, c.132 (C.54:18A-3).
L.2009, c.75, s.7.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.59c - Submission of financial and demographic data

26:2H-18.59c. Submission of financial and demographic data
14. All acute care hospitals licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et al.) shall submit to the department all demographic and financial data specified in this section, in a manner and time frame specified by the commissioner.
a. A hospital shall submit demographic information about the persons who qualify for charity care or to whom the hospital provides uncompensated care, which includes, at a minimum: the individual's age, sex, marital status, employment status, type of health insurance coverage, if any, and if the individual is a child under 18 years of age who does not have health insurance coverage or a married person who does not have health insurance coverage, whether the child's parent or the married person's spouse, as the case may be, has health insurance.
b. A hospital shall submit all financial data required by the department for the purposes of calculating the payer mix factor as defined in sections 12 and 13 of P.L.1995, c.133 (C.26:2H-18.59a and C.26:2H-18.59b) and section 7 of P.L.1996, c.28 (C.26:2H-18.59e).
c. A hospital which fails to provide the information required pursuant to this section in a manner and time frame specified by the commissioner, shall be liable to a civil penalty not to exceed $1,000 for each day in which the hospital is not in compliance. The commissioner shall recover the penalty in an administrative proceeding held pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.).
L.1995,c.133,s.14; amended 1996,c.28,s.5.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.59d - Continuation of provided services

26:2H-18.59d Continuation of provided services
15. Unless the commissioner has granted written approval to do otherwise, an acute care hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et al.) shall continue to provide, at an annual service level at least equal to that provided as of January 1, 1993, any public health services which were, prior to that date, supported by grant funds. A hospital shall also provide sufficient funds for the operation of its regional hemophilia centers, maternal and child health consortia and other regional health services, as applicable.
L.1995,c.133,s.15.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.59g - Establishment of technology infrastructure to support the provision of charity care.

26:2H-18.59g Establishment of technology infrastructure to support the provision of charity care.
9. The Commissioner of Health, in consultation with the State Treasurer, shall establish a technology infrastructure to support the provision of charity care pursuant to P.L.1992, c.160 (C.26:2H-18.51 et al.).
The State Treasurer, in consultation with the Commissioners of Health and Human Services may, if deemed to be in the State's best interests, include system features and provisions in the technology infrastructure to satisfy the requirements of multiple programs and purposes, including, but not limited to, programs such as, Medicaid, food stamps, public assistance, and purposes such as the exchange and consolidation of health care information permitted by law, eligibility and identity verification, claims processing, the use of electronic patient identification technology, and electronic data interchange.
L.1996, c.28, s.9; amended 1998, c.37, s.3; 2012, c.17, s.228.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.59h - Transferred employees guaranteed equivalent health insurance coverage.

26:2H-18.59h Transferred employees guaranteed equivalent health insurance coverage.
11. In the event that a hospital or other health care institution that receives a charity care subsidy pursuant to P.L.1992, c.160 (C.26:2H-18.51 et al.) or funds from the Hospital Health Care Subsidy account in the Department of Human Services, sells, leases, assigns, subcontracts or otherwise transfers ownership, control or management of any of its services to another entity, the hospital or other health care institution shall provide that the new entity guarantee to offer to its employees who were affected by the transfer, health insurance coverage at substantially equivalent levels, terms and conditions to those that were offered to the employees prior to the transfer.
L.1997,c.263,s.11.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.59j - Charity claims by hospital, eligibility.

26:2H-18.59j Charity claims by hospital, eligibility.
6. Notwithstanding the provisions of section 3 of P.L.2004, c.113 (C.26:2H-18.59i) to the contrary, a hospital shall not submit charity care claims to the Department of Health for health care services provided to a child under 19 years of age who presents at a hospital for emergency care and who may be deemed presumptively eligible for NJ FamilyCare coverage pursuant to P.L.2005, c.156 (C.30:4J-8 et al.) or Medicaid coverage pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
L.2008, c.38, s.6; amended 2012, c.17, s.230.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.60 - Uniform charity care eligibility and reimbursement claim form

26:2H-18.60. Uniform charity care eligibility and reimbursement claim form
10. a. The commissioner shall establish a uniform charity care eligibility and reimbursement claim form that a hospital shall be required to use in order to receive reimbursement for charity care under this act.
b. A person whose individual or, if applicable, family gross income is less than or equal to 300% of the poverty level shall be eligible for charity care or reduced charge charity care for necessary health care services provided at a hospital.
The commissioner shall establish:
(1) the maximum level of income at which a person is eligible for full charity care;
(2) a sliding scale based on income which specifies the percentage of hospital charges for which a person who is eligible for reduced charity care is responsible; and
(3) assets eligibility criteria for full charity care and reduced charge charity care, respectively.
L.1992,c.160,s.10; amended 1995,c.133,s.6.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.60b - Findings, declarations relative to oversight of the hospital charity care subsidy program.

26:2H-18.60b Findings, declarations relative to oversight of the hospital charity care subsidy program.
2. The Legislature finds and declares that it is manifestly in the best interest of this State and its taxpayers to enact into law certain recommendations made by the New Jersey State Commission of Investigation in its April 2007 report on the hospital charity care subsidy program and to implement additional measures which are designed to prevent real and potential waste, fraud, and abuse in this program and ensure that it serves its intended purpose of assisting hospitals to meet their statutory obligations and fulfill their mission as essential health care providers to the residents of this State.
L.2007,c.217,s.2.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.60c - Required procedures by hospitals for charity care.

26:2H-18.60c Required procedures by hospitals for charity care.
3. The Commissioner of Health shall require the use of procedures by hospitals to ensure their uniform collection from applicants for charity care pursuant to section 10 of P.L.1992, c.160 (C.26:2H-18.60) and the transmission to the Department of Health of demographic and financial information as the commissioner requires pursuant to section 14 of P.L.1995, c.133 (C.26:2H-18.59c) and any other information that the commissioner determines necessary to ensure the efficient, cost-effective operation of the hospital charity care subsidy program and to prevent and detect fraudulent charity care claims.
L.2007, c.217, s.3; amended 2012, c.17, s.231.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.60d - Interagency agreement with Medicaid Inspector General.

26:2H-18.60d Interagency agreement with Medicaid Inspector General.
4. a. The Commissioner of Health and the Medicaid Inspector General shall establish an inter-agency agreement under which the staff and resources of the Office of the Medicaid Inspector General are utilized to:
(1) investigate charity care claims, which that office or the Department of Health reasonably suspects may be fraudulent, with the same authority as that granted to the Medicaid Inspector General to investigate complaints related to Medicaid integrity, fraud, and abuse pursuant to P.L.2007, c.58 (C.30:4D-53 et al.); and
(2) recover monies from third party payers that were paid as charity care subsidies based upon fraudulent charity care claims.
b. The commissioner and the Medicaid Inspector General shall take such actions as are necessary to ensure that any monies recovered pursuant to subsection a. of this section are deposited in the Health Care Subsidy Fund and used for the purposes of providing charity care subsidies pursuant to P.L.1992, c.160 (C.26:2H-18.51 et al.).
L.2007, c.217, s.4; amended 2012, c.17, s.232.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.60e - Inter-agency agreement with State Treasurer.

26:2H-18.60e Inter-agency agreement with State Treasurer.
5. The Commissioner of Health and the State Treasurer shall establish an inter-agency agreement under which the staff and resources of the Division of Taxation in the Department of the Treasury are utilized to conduct random checks of personal State income tax returns filed by persons determined eligible for charity care pursuant to section 10 of P.L.1992, c.160 (C.26:2H-18.60), in consultation with the commissioner, and with the Medicaid Inspector General pursuant to section 4 of P.L.2007, c.217 (C.26:2H-18.60d), for the purposes of determining the validity of charity care claims for health care services provided to those persons.
L.2007, c.217, s.5; amended 2012, c.17, s.233.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.60f - Reporting system established.

26:2H-18.60f Reporting system established.
7. The Commissioner of Health shall establish a mechanism, by means of a toll-free telephone hotline or electronic mail, through which persons may confidentially report suspected incidents of fraudulent charity care claims to the Department of Health.
L.2007, c.217, s.7; amended 2012, c.17, s.234.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.60g - Recovery for fraudulent claim.

26:2H-18.60g Recovery for fraudulent claim.
8. If a charity care claim is determined to be fraudulent, a hospital shall be entitled to recover from the patient the difference between the amount of the charity care claim and the amount that the patient would have otherwise been charged by the hospital to provide the health care services for which the charity care claim was filed.
L.2007,c.217,s.8.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.64 - Denial of admission on ability to pay; penalty

26:2H-18.64. Denial of admission on ability to pay; penalty
14. No hospital shall deny any admission or appropriate service to a patient on the basis of that patient's ability to pay or source of payment.
A hospital which violates this section shall be liable to a civil penalty of $10,000 for each violation. The penalty shall be sued for and recovered pursuant to "the penalty enforcement law," N.J.S.2A:58-1 et seq. and shall be deposited in the fund.
L.1992,c.160,s.14.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.65 - Establishment of Health Access New Jersey program; regulations; administration

26:2H-18.65. Establishment of Health Access New Jersey program; regulations; administration
15. There is established in the Department of Health the Health Access New Jersey program. The purpose of the program is to provide subsidies for health benefits coverage, in order to provide for health care for low income, uninsured children, working people and those temporarily unemployed, based on a sliding income scale with modest copayments. The program shall include the provision of early preventive and primary care.
The commissioner shall adopt regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) that determine eligibility for the program and the allocation of all funds in this account.
The commissioner shall contract with health insurance carriers, health maintenance organizations and other appropriate entities in the State to administer the program.
L.1992,c.160,s.15; amended 1995, c.133, s.10; 1996,c.29,s.1.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.66 - Allocation to Health Access New Jersey subsidy account.

26:2H-18.66 Allocation to Health Access New Jersey subsidy account.
16. The Health Access New Jersey subsidy account shall be allocated $50 million in 1995, $10 million in 1996, $25 million in 1997, $10 million for the period from January 1, 1998 through June 30, 1998 and $20 million in fiscal year 1999 and each fiscal year thereafter.
L.1992,c.160,s.16; amended 1995, c.133, s.11; 1996, c.29, ss.2,3; 1997, c.263, s.7.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.68 - Appropriation from "Uncompensated Care Reduction - Pilot Program" account

26:2H-18.68. Appropriation from "Uncompensated Care Reduction - Pilot Program" account
36. The monies in the "Uncompensated Care Reduction--Pilot Program" account of the New Jersey Uncompensated Care Trust Fund established pursuant to P.L.1989, c.1, as that account was continued in section 18 of P.L.1991, c.187 (C.26:2H-18.40), are appropriated to the Essential Health Services Commission for the New Jersey SHIELD program established pursuant to this act.
L.1992,c.160,s.36.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.69 - Appropriation of remaining monies

26:2H-18.69. Appropriation of remaining monies
37. Any monies remaining in the New Jersey Health Care Trust Fund, including the reserve required pursuant to section 4 of P.L.1991, c.187 (C.26:2H-18.27), are appropriated to the Health Care Subsidy Fund in the Essential Health Services Commission.
L.1992,c.160,s.37.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.72 - Provision of renal dialysis treatment services, medication to uninsured low-income persons.

26:2H-18.72 Provision of renal dialysis treatment services, medication to uninsured low-income persons.
1. a. As a condition of licensure and renewal, an ambulatory care facility that is licensed to provide chronic renal dialysis services shall in each calendar year provide uncompensated renal dialysis treatment, services and medication associated with dialysis treatment for uninsured low-income persons in an amount up to 3.5% of the total number of renal dialysis treatments provided by the facility during that year.
b. As used in this act, "uninsured low-income person" means a patient who:
(1) is a resident of New Jersey;
(2) has an individual or, if applicable, family gross income that would qualify that person for charity care pursuant to section 10 of P.L.1992, c.160 (C.26:2H-18.60); and
(3) has no health insurance coverage for the renal dialysis treatment and services provided.
c. Compliance with the requirements of this act may be calculated on an aggregate basis for separately licensed ambulatory care facilities in this State that have common ownership, except that the total amount of uncompensated renal dialysis treatment and services provided shall equal the sum of the amounts required for each separately licensed facility.
L.2007,c.79,s.1.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.73 - Annual report to Legislature.

26:2H-18.73 Annual report to Legislature.
3. The Commissioner of Health and Senior Services shall annually report to the Legislature, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), on the number of patients who receive treatment at each facility pursuant to this act who are not eligible for Medicare or Medicaid, the number of treatments provided to those patients, and such other information as he deems appropriate.
L.2007,c.79,s.3.
2023 New Jersey Revised Statutes › Title 26 - Health and Vital Statistics › Section 26:2H-18.75 - Findings, declarations relative to health care facilities.

26:2H-18.75 Findings, declarations relative to health care facilities.
2. The Legislature finds and declares that:
a. The final report of the New Jersey Commission on Rationalizing Health Care Resources, issued on January 24, 2008, demonstrated that a large number of New Jersey general hospitals are in poor financial health and in financial distress due to a number of causes, including lack of universal coverage, underpayment by public payers, misaligned incentives and interests between physicians and hospitals, lack of transparency of performance or cost, a need for more responsible governance at certain hospitals, and excessive geographic hospital density;
b. The financial challenges faced by general hospitals in New Jersey have caused many to close in recent years, and additional hospitals may close in the future;
c. A general hospital's sudden closure or significant reduction in services can threaten access to health care providers and specialized health care services in the hospital's primary service area;
d. It is vitally important to the residents of this State that continuity and stability be maintained when a general hospital closes or reduces services in order to assure access to high-quality and cost-effective health care services and referrals to residents of the affected community;
e. It is fitting and appropriate that the State of New Jersey provide temporary funding to continue access to and availability of health care services in time of emergent need and to condition that funding on adherence to requirements to ensure efficient and effective delivery of health care services; and
f. To that end, the Health Care Stabilization Fund is established for the purpose of providing emergency grants to general hospitals and other licensed health care facilities to ensure continuation of access and availability of necessary health care services to residents in a community served by a hospital facing closure or significantly reducing services due to financial distress.
L.2008, c.33, s.2.