summary
Introduced
06/28/2023
06/28/2023
In Committee
06/28/2023
06/28/2023
Crossed Over
Passed
Dead
01/08/2024
01/08/2024
Introduced Session
2022-2023 Regular Session
Bill Summary
Prohibits downcoding in health insurance claims.
AI Summary
This bill prohibits "downcoding" in health insurance claims. Downcoding refers to the practice of adjusting a health insurance claim to a less complex or lower-cost service in order to reimburse the provider at a lower amount than what is required under the provider contract. The bill requires payers, which include insurance companies and organized delivery systems, to allow healthcare providers to submit claims for the actual service performed and receive the corresponding reimbursement. The Department of Banking and Insurance is tasked with adopting regulations to enforce the purposes of this law, which will take effect 180 days after enactment.
Committee Categories
Business and Industry
Sponsors (1)
Last Action
Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 06/28/2023)
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/A5682 |
| BillText | https://pub.njleg.gov/Bills/2022/A6000/5682_I1.HTM |
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