Medicaid Managed Care Contract | July 31, 2019
New Jersey Medicaid Managed Care Contracts & Winning Proposals
New Jersey contracts with five health plans to deliver physical health and long-term services and supports (LTSS) for most populations, including families and children, Medicaid expansion adults, and aged and disabled adults.
Most behavioral health benefits are included in the health plan’s capitation rate for individuals receiving managed long-term services and supports (MLTSS) and Department of Development Disability services, as well as for dual eligibles enrolled in an aligned D-SNP. The health plans are responsible for all hospital admissions, including psychiatric unit admissions in general acute hospitals, psychiatric hospitals, and specialty care hospitals. The health plans . . .
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