Legislation to Combat Surprise Out-of-Network Medical Bills Approved by Assembly

Pro-patient legislation  to protect patients by eliminating surprise out-of-network medical bills was approved 48-21-3 by the Assembly. The bill was sponsored by Assembly Speaker Craig Coughlin, Assemblyman Gary Schaer and Assemblywoman Pamela Lampitt.

The bill (A-2039) is designed to help those burdened by surprise medical bills after medically necessary emergency services or inadvertent out-of-network care. It was advanced Thursday by the Assembly Appropriations Committee.

It reforms the health care delivery system in New Jersey to increase transparency in pricing for health care services, enhance consumer protections, create an arbitration system to resolve billing disputes and contain rising costs associated with out-of-network health care services.

“Far too many New Jersey families – even those with quality health benefits plans – find themselves fighting over thousands of dollars in out-of-network charges they never even had the opportunity to review – let alone agree to – before receiving medical attention,” said Coughlin (D-Middlesex). “This is about putting patients first and defending the consumer’s right to be able to make an informed decision about how to proceed with his or her health care.”

“If given the choice between continuing with medical care that ultimately would lead to substantial out-of-pocket costs and considering other options that carry a lower price tag, the vast majority of reasonable New Jersey residents certainly would choose the latter, but the problem, at present, is that they don’t have that choice,” said Schaer (D-Bergen/Passaic). “By implementing these reforms, increased transparency in out-of-network services chief among them, this legislation will make health care more affordable for consumers and make the system more efficient overall.”

“This is a pro-patient legislation that will keep residents aware of out-of-network services or doctors,” said Lampitt (D-Camden/Burlington). “It is time we introduce a level of transparency to the health care industry in New Jersey to enable everyone involved to make well-informed decisions.”

The expansive bill reforms several aspects of the state’s health care system involving disclosure, out-of-network billing, arbitration, increased transparency and provider network audits.

It also requires the state to issue a report to the governor and Legislature within one year, and annually thereafter, on the savings to policyholders and the healthcare system resulting from the bill’s enactment.


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There are 2 Comments to "Legislation to Combat Surprise Out-of-Network Medical Bills Approved by Assembly"

  • Ari says:

    They claim it is pro patient but it is really anti doctor and pro insurance industry. The bill makes it illegal for providers, even out of network providers to waive, or give back any part of the co-pay owed by the patient. This makes it more costly for patients to use out of network providers, and pushes doctors, therapists etc. to joins in network plans that pay them lower rates…

  • chaimyankel says:

    I recently underwent caediac stenting as an emergency patient- Dr. who did the procedure worked on me for less than 2 hours- found out afterwards that he does not accept insurance asignment and billed me for the nice sum of 38 Thousand dollars- after reviewing the case – BC paid it in FULL-
    The kicker is that he is on stafff of the hospital- many doctors practices are owned by the hospital-

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