New benefits for autism spectrum disorders, diabetes, Hepatitis C, and family planning services; Implements waiver to expand opioid use disorder treatment

The proposed Fiscal Year 2019 Budget unveiled by Governor Murphy last week includes several actions to update and modernize New Jersey’s Medicaid Program.  New Jersey’s Medicaid and Children’s Health Insurance Program (CHIP) – together known as NJ FamilyCare – provide health care coverage to more than 1.7 million New Jerseyans, including more than 800,000 children.  In total, the Governor’s proposed budget includes $4.3 billion in state funding to provide comprehensive health care coverage for residents with low incomes.

“Building a stronger and fairer New Jersey for all residents includes ensuring that we are continually improving our Medicaid program to give New Jersey families access to the services they need,” said Acting Commissioner of the Department of Human Services Carole Johnson. “The Governor’s budget delivers on that commitment with new Medicaid coverage for autism spectrum disorders, diabetes, Hepatitis C, and family planning services, and implementation of a Medicaid waiver to expand treatment for opioid use disorder.”

New and expanded Medicaid benefits in the Budget include:

New Autism Spectrum Disorder Benefits: The Budget includes $17 million in new State and federal funds to cover Autism Spectrum Disorder benefits in NJ FamilyCare.  To date, New Jersey has only covered select services for a small population in a pilot program.  It is estimated over 10,000 youth have an Autism Spectrum Disorder diagnosis, and the budget would give young people with Medicaid coverage access to appropriate screening and treatment.

New Diabetes Benefits: The Budget assumes implementation of legislation adding new Medicaid coverage of diabetes self-management education and training, medical nutrition therapy, the National Diabetes Prevention Program, and supplies and equipment to the Medicaid program.  These services and programs are designed to better prevent, treat and manage one of the leading chronic diseases in our State.

Expanded Hepatitis C Treatment: The Budget assumes coverage of curative Hepatitis C drugs for all Medicaid enrollees with a Hepatitis C diagnosis.  Today, NJ Medicaid restricts who is eligible for treatment.  New Jersey has lagged behind neighboring states, which provide more comprehensive access to treatment for Medicaid enrollees.

Expanded Family Planning Benefits: The Budget provides over $11 million in State and federal funds to expand family planning services provided through NJ FamilyCare to residents with incomes up to 200% of the federal poverty level. These newly eligible recipients will have access to a package of family planning-related services. The Budget also assumes implementation of Medicaid coverage for post-partum coverage of long-acting reversible contraception, allowing New Jersey to remove a restriction limiting access to one of the most effective forms of contraception.

Treating Opioid Use Disorder: The NJ FamilyCare budget also assumes funding to implement a waiver that will offer a more complete Medicaid service package to assist those who are battling opioid and other substance use disorders.  Implementation will expand Medicaid coverage of peer services and case management services for individuals with a substance use disorder and include coverage for detox, short-term and long-term residential rehabilitation services.

Going forward, the Murphy Administration will continue to identify opportunities to strategically enhance Medicaid benefits and services to ensure that New Jerseyans have access to the care they need.