Bill > S1903

This bill establishes a process for barring certain health care providers from receiving reimbursement under personal injury protection (PIP) coverage, which is a type of automobile insurance that covers medical expenses and lost wages for injuries sustained in a car accident, and medical expense benefits coverage. The Commissioner of Banking and Insurance, in consultation with other state officials, will create regulations to investigate and potentially suspend or permanently bar providers who are suspected of professional misconduct, incompetence, negligence, knowingly making false statements on medical reports related to claims, soliciting patients for treatment in connection with claims, refusing to cooperate with investigations, or engaging in patterns of billing for services that were not rendered, are of no diagnostic value, or are medically unnecessary. The regulations will ensure providers have due process, including notice and an opportunity to be heard, and will be publicly accessible through websites and a toll-free number. The bill also allows for temporary suspension of reimbursement for up to 90 days during an investigation, and providers barred from reimbursement are prohibited from treating patients seeking payment under these insurance coverages as private patients.