Bill

Bill > S776


NJ S776

Requires carriers to offer health care providers more than one method of payment for reimbursement.


summary

Introduced
01/09/2024
In Committee
01/09/2024
Crossed Over
Passed
01/09/2024
Dead
01/09/2024

Introduced Session

2024-2025 Regular Session

Bill Summary

This bill provides that any network agreement between a carrier, or the carrier's contracted vendor, and a health care provider for the provision of health or dental care services is prohibited from mandating only one form of payment to the health care provider. A carrier, or the carrier's vendor, is also prohibited from restricting the method of payment to an out-of-network health care provider providing out-of-network covered services to only one form of payment. The bill also requires a carrier, or the carrier's contracted vendor, to provide certain information to a health care provider, prior to initiating its first payment to the health care provider, where one of the available payment methods includes a fee and before changing the available payment methods. The bill prohibits a carrier from using a health care provider's preferred method of payment as a factor when deciding whether to provide credentials to a health care provider.

AI Summary

This bill prohibits carriers, or their contracted vendors, from mandating only one form of payment to in-network healthcare providers or restricting out-of-network providers to only one payment method. It requires carriers to provide information to providers about any fees associated with available payment methods and to allow providers to change their preferred payment method within 30 business days. The bill also prohibits carriers from using a provider's preferred payment method as a factor in credentialing decisions. The provisions of the bill cannot be waived by contract, and violations may result in civil penalties and reimbursement of provider fees. Key terms include "carrier" (insurance companies, health service corporations, etc.) and "health care provider" (licensed professionals and facilities).

Committee Categories

Business and Industry

Sponsors (5)

Last Action

Withdrawn Because Approved P.L.2023, c.247. (on 01/09/2024)

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