Bill
Bill > A2413
NJ A2413
Permits payment of only one co-payment or deductible for follow-up care or treatment after surgery or illness under certain health benefits plans.
summary
Introduced
02/07/2022
02/07/2022
In Committee
02/07/2022
02/07/2022
Crossed Over
Passed
Dead
01/08/2024
01/08/2024
Introduced Session
2022-2023 Regular Session
Bill Summary
This bill supplements the "Health Care Quality Act," P.L.1997, c.192 (C.26:2S-1 et seq.) to provide that, when a covered person is receiving post-operative follow-up care, follow-up care for the treatment of a diagnosed illness or condition, or other follow-up care for any other covered service, which follow-up care is provided by a participating provider, the covered person shall be responsible for the payment of only one co-payment or deductible to the participating provider under the plan during any period of 180 days following the payment of that co-payment or deductible. The bill further prohibits the participating provider from collecting more than one such co-payment or deductible, during any period of 180 days following the payment of that co-payment or deductible, regardless of the number of follow-up care visits during that period. The provisions of the bill would only apply if the covered person complies with the preauthorization or review requirements of the health benefits plan regarding the determination of medical necessity to access in-network inpatient benefits.
AI Summary
This bill supplements the "Health Care Quality Act" to provide that when a covered person is receiving post-operative follow-up care, follow-up care for a diagnosed illness or condition, or other follow-up care from a participating provider, the covered person shall be responsible for only one co-payment or deductible within a 180-day period. The bill also prohibits the participating provider from collecting more than one such co-payment or deductible during that 180-day period, regardless of the number of follow-up visits. These provisions only apply if the covered person complies with the preauthorization or review requirements of the health benefits plan regarding the determination of medical necessity to access in-network inpatient benefits.
Committee Categories
Business and Industry
Sponsors (1)
Last Action
Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 02/07/2022)
Official Document
bill text
bill summary
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bill summary
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bill summary
Document Type | Source Location |
---|---|
State Bill Page | https://www.njleg.state.nj.us/bill-search/2022/A2413 |
BillText | https://www.njleg.state.nj.us/Bills/2022/A2500/2413_I1.HTM |
Bill | https://www.njleg.state.nj.us/Bills/2022/A2500/2413_I1.PDF |
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