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Bill > A566


NJ A566

NJ A566
Concerns standards for non-renewal or termination of certain health care professionals from insurance carrier's provider network.


summary

Introduced
01/11/2022
In Committee
01/11/2022
Crossed Over
Passed
Dead
01/08/2024

Introduced Session

2022-2023 Regular Session

Bill Summary

This bill requires carriers which offer managed care plans to establish a policy governing removal of health care providers from the provider network that provides, if a licensed health care professional has been participating in the carrier's provider network for five years or longer, the carrier may not fail to renew or terminate the professional's contract, unless the carrier: (1) provides the health care professional and the commissioner with written notice of the non-renewal or termination one year prior to the effective date of the non-renewal or termination, which documents the cause for the professional's non-renewal or termination; and (2) the commissioner finds that the non-renewal or termination is with good cause. The bill requires the Commissioner of Banking and Insurance to adopt regulations within 180 days of the date of enactment of this act, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), necessary to carry out the purposes of the bill, which are to include standards for what constitutes good cause for non-renewal or termination of a licensed health care professional.

AI Summary

This bill requires health insurance carriers that offer managed care plans to establish a policy governing the removal of health care providers from their provider networks. The key provisions are: (1) if a licensed health care professional has been participating in the carrier's network for 5 years or longer, the carrier cannot fail to renew or terminate the professional's contract unless the carrier provides 1 year's written notice documenting the cause and the Commissioner of Banking and Insurance finds the non-renewal or termination is with "good cause"; and (2) the Commissioner must adopt regulations within 180 days to establish standards for what constitutes "good cause" for such non-renewal or termination.

Committee Categories

Business and Industry

Sponsors (1)

Last Action

Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 01/11/2022)

bill text


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