NJ assembly committee OKs legislation targeting surprise medical bills: 7 things to know

A New Jersey General Assembly committee has approved legislation that targets surprise out-of-network medical bills, according to NJ.com.

Here are seven things to know about the legislation.

1. The legislation, Bill A1952, was approved Monday by the Assembly Insurance and Financial Institutions Committee. The vote was 9-3.

2. Under the legislation, hospitals and physicians would be required to reveal whether they are part of a patient's insurance network before treatment occurs, according to the report. The report states that the legislation would also create a state-regulated binding arbitration process to settle disputed bills for out-of-network emergency care. Additionally, hospitals would have to post on their website a list of standard charges for the services they provide, and a list of physicians who are employed by or have a contract with the hospital and their contact information.

3. New Jersey lawmakers have made multiple attempts to pass legislation reining in surprise medical bills. However, influential lobbyists representing physicians, hospital and payers have stymied those efforts by fighting over the details, according to the report.

4. This time around, hospital lobbyists and physicians also have concerns. Their biggest concern is how the arbitrator's decision would limit disputed reimbursement from 90 percent to 200 percent of what Medicare covers for treating the elderly, according to NJ.com. Under the legislation, the arbitrator's fees would be split by the insurance carrier and medical provider.

5. Supporters, too, expressed concerns about how the arbitration system would work. "The arbitration is something we need to work out and resolve, but we are getting there and making great progress," Committee Vice-Chairwoman Pamela Lampitt (D-Camden) said, according to NJ.com.

6. The bill would have little effect on self-funded, federally regulated insurance plans that are not bound by state law. These plans represent 70 percent of New Jersey residents, according to the report.

7. In addition to Bill A1952, the committee also approved a companion bill, A2866, which would create a healthcare price index containing billing claims data.


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