Community Living Policy Center

New Jersey

New Jersey

New Jersey Comprehensive Waiver

In 2014, New Jersey began providing Medicaid managed long-term services and supports through its FamilyCare Comprehensive Demonstration (formerly Comprehensive Waiver) program, which has operated since 2012 under the authority of Section 1115 of the Social Security Act.  Participation is mandatory for nearly all populations.
 

Capitation rates for people receiving LTSS vary by Medicare coverage (dual versus non-dual) and by residential setting.  There is one tier for people receiving HCBS and another for people in nursing homes.  Enhanced rates apply to people in what are termed special care nursing facilities.  Capitation rates for non-LTSS recipients depend on eligibility category and age group.

More information

 

Program documents

Contract with managed care organizations:
 
NJ Comprehensive Waiver 1115 Application:
 
NJ Comprehensive Waiver Annual Report:
 
Request for Waiver Amendment:
 
Draft Waiver Renewal Application 2016:
 
CMS Special Terms & Conditions:
 
Description of assessment tool for personal care services:
 
Managed Care Quality Strategy:
 
For capitation rates, see Section C of the contract with managed care organizations, above.

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