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  • NJ A2328
  • Requires health insurance carriers to comply with certain network adequacy requirements.
Introduced
(2/4/2016)
In Committee
(4/4/2016)
Crossed OverPassedSignedDead/Failed/Vetoed
2016-2017 Regular Session
This bill requires health insurance carriers to comply with certain network adequacy requirements. The bill prohibits the Commissioner of Banking and Insurance from issuing conditional approval of provider network adequacy. The bill provides that in the case of a carrier seeking approval for a tiered network, the preferred tier of the network must separately meet all requirements for provider network adequacy. The bill also provides that each health care provider that is used to meet provider network adequacy requirements shall be in the carrier's network or, in the case of a tiered network, in the same tier of the tiered network, for all covered services provided by that provider. Under the bill, "tiered network" means a managed care plan provider network with more than one level or tier of in-network benefits, based on different levels of reimbursement and cost sharing accepted by the health care providers in that network. "Network adequacy" means the adequacy of the provider network with respect to the scope and type of health care benefits provided by the carrier, the geographic service area covered by the provider network, and access to medical specialists pursuant to the standards in the regulations promulgated pursuant to section 19 of P.L.1997, c.192 (C.26:2S-18).
2nd Reading in the Assembly, Regulatory Oversight and Reform and Federal Relations
Reported out of Assembly Committee, 2nd Reading  (on 4/4/2016)
 
 

Date Chamber Action Description
4/4/2016 Assembly Regulatory Oversight and Reform and Federal Relations Hearing (14:00 4/4/2016 Committee Room 12, 4th Floor)
4/4/2016 A Reported out of Assembly Committee, 2nd Reading
4/4/2016 Assembly Regulatory Oversight and Reform and Federal Relations Hearing (14:00 4/4/2016 Committee Room 14, 4th Floor)
3/7/2016 Assembly Regulatory Oversight and Reform and Federal Relations Hearing (14:00 3/7/2016 Committee Room 14, 4th Floor)
2/4/2016 A Introduced, Referred to Assembly Regulatory Oversight and Reform and Federal Relations Committee
Date Motion Yea Nay Other
Detail 4/4/2016 Assembly Regulatory Oversight Committee: Reported Favorably 3 2 0