The State Health Benefits Program Plan Design Committee (PDC) met for its regularly scheduled meeting on September 27.
The PDC approved Resolution 2023-13, expanding eligibility for the First Responders Direct Primary Care Medical Home Pilot Program by modifying the resolution ( 2019-02) that created the pilot program.
Under the resolution, members eligible as “first responders” are those who respond to emergencies or regularly required by their job description to engage with clients or patients who are experiencing trauma. Among the titles now eligible for the Pilot Program are Public Safety Telecommunicator Trainee, Public Safety Telecommunicator, Senior Public Safety Telecommunicator, Supervising Public Safety Telecommunicator, Chief Public Safety Telecommunicator, and County Emergency Management Coordinator.
During the July meeting, the committee adopted Resolution 2023-09 to adopt a final Reference Based Pricing resolution. That motion was tabled and is expected to be considered at the October meeting.
The superconciliation update noted that the First Responder Title issue has been resolved, progress is being made on Reference Based Pricing, and the PDC expects to begin discussions about Specialty Medicine cost concept in the near future.
Aetna discussed minor Current Dental Terminology (CDT) code changes to the Dental Plan.
The next PDC meeting is scheduled for October 25.
Contact: Paul Penna, Senior Legislative Analyst, ppenna@njlm.org, 609-695-3481, x110.