A 4790 — Makes certain changes to regulation of health care service firms.

A4790 1R [First Reprint] ASSEMBLY, No.

  CURRENT VERSION OF TEXT      As introduced.amended by the General Assembly on June 11, 2026.

P.L.2020, c.132, s.1)             2.12.  Section 2 of P.L.2014, c.29 (C.

 The34:8-45.1a) Divisionis ofamended Consumerto Affairsread in the Department of Law and Public Safety shall adopt rules and regulations, in accordance with the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et seq.), as arefollows: necessary to effectuate the provisions of this act.

           2.   3.a.

 ThisThe actDirector of the Division of Consumer Affairs in the Department of Law and Public Safety shall takeenter effectinto immediately.a memorandum of understanding with an accrediting body chosen by the director through appropriate procurement processes authorized to accredit a health care service firm pursuant to subsection c.

 of  section STATEMENT1  of     P.L.2002, Thisc.126 bill(C.34:8-45.1).  makesThe variousmemorandum changesof tounderstanding shall establish the regulationstandards for accreditation and for reporting the results of healthaudits careperformed servicepursuant firms.to subsection d.

    of Thesection bill:1 of P.L.2002, c.126 to the Division.

1)      raisesb.   the[The annualdirector Medicaidshall, reimbursementin thresholdconsultation forwith personalrepresentatives of health care assistanceservice servicesfirms thatregistered wouldwith triggerthe division, develop an auditagreed-upon set of standards and procedures for independent third party practitioners to review health care service firmsfirm fromfinancial $250,000statements and records, general management, and internal controls pursuant to $500,000;paragraph (4) of subsection d.

2)of requiressection the1 healthof careP.L.2002, servicec.126 firms(C.34:8-45.1).  toAt submita minimum, the auditstandards noand laterprocedures thandeveloped Septemberpursuant 30thto ofthis thesubsection calendarshall yearaddress: in which it is due;

3)      revises(1)  the compensationminimum thresholdeducational, fortraining, reportingand requirementsprofessional forcertification healthqualifications carefor serviceindependent firmsthird fromparty betweenpractitioners $1performing millionreviews andof $10health million,care toservice lessfirm thanfinancial $10statements million;and records;

4)      revises(2)  the informationdata thatpoints isand metrics to be containedincluded in thea review of a health care service firm’sfirm's report;financial statements and records, general management, and internal controls which shall include, at a minimum, verification of the accreditation and licensing status of the firm;

5)review providesof forthe correctivefirm's actionownership instructure; certain cases;

review of contracts and 6)funding permitssources auditsas towell beas performedpayments, bycash out-of-Statetransactions, accountants.and reconciliation of account balances;

review of the adequacy of the firm's insurance coverage;

review of billing practices and invoices to ensure the adequacy of supporting documentation and the inclusion of appropriate authorizations;

review of any history of litigation involving the firm, regulatory actions taken against the firm, or past audits of the firm;

review of the use of independent contractors;

and review of large transactions and liabilities that exceed a specified percentage of the firm's total billings or liabilities, as appropriate;

and       (3)  the thresholds and requirements for the division to make an adverse finding and take corrective action against a firm based upon a review of an independent third party report concerning the firm's financial statements and records.] (Deleted by amendment, P.L.   , c.  ) (pending before the Legislature as this bill).

1 (cf:

P.L.2020, c.132, s.2)        1[2.]  3.1  The Division of Consumer Affairs in the Department of Law and Public Safety shall adopt rules and regulations, in accordance with the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et seq.), as are necessary to effectuate the provisions of this act.

       1[3.]  4.1  This act shall take effect immediately.