A state assembly panel approved a bill in June that would set limits on what out-of-network hospitals and physicians could charge patients and their health plans for services and create an arbitration process to settle payer-provider disputes. California passed a similar bill this fall.
But the proposed legislation, Bill A1952, sparked outrage among some healthcare groups and caused the bill to stall.
Assemblyman Craig Coughlin (D-Middlesex) said the delays are understandable given the “zealous resistance” by some hospitals and physicians. “Candidly we have to realize this is not the kind of bill that is going to produce a win-win-win” for the parties involved.
Though New Jersey has implemented some balance billing legislation, insurance advocates argue the well-intended bills have contributed to the problem. Law prohibits out-of-network providers from charging patients more than their in-network insurance rate for emergency services. But this caused the insurer to absorb outstanding costs, which can be exorbitant.
In response, some payers have fought to reduce their network rates to recoup costs.
Opponents of Bill A1952 argue it is worthless to introduce more balance billing laws if the state cannot effectively enforce those it has already implemented, according to the article.
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