Bill > A3950

Introduced Session

This bill would prohibit a hospital from billing certain patients for laboratory services in an amount that exceeds 150% of the applicable payment rate under the federal Medicare program. Under existing law, at P.L.2008, c.60 (C.26:2H-12.52 et seq.), whenever a hospital provides health care services (including laboratory services) to an uninsured patient whose family gross income is less than 500% of the federal poverty level, the hospital is prohibited from charging the patient more than 115% of the applicable payment rate for those services under the federal Medicare program. This bill would establish a similar cap on charges for laboratory services that are provided to patients who do not satisfy the income and other requirements of P.L.2008, c.60. In particular, the bill would provide that, except in cases where the provisions of P.L.2008, c.60 are applicable, a hospital will be prohibited from charging a patient in this State more than 150% of the applicable payment rate under the federal Medicare program for any laboratory services that are rendered to the patient. The existing 115% cap established under P.L.2008, c.60 would still be applicable to laboratory and other health care services that are provided by a hospital to uninsured persons who satisfy the applicable income requirements.

AI Summary

Committee Categories

Annette Quijano (D)*, 

Introduced, Referred to Assembly Health Committee (on 05/12/2022)

Official Document