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Bill > A1452


NJ A1452

NJ A1452
Concerns standards for non-renewal or termination of certain health care professionals from insurance carrier's provider network.


summary

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

Introduced Session

2024-2025 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 to establish a policy for removing health care professionals from their provider networks. If a licensed health care professional has been participating in the carrier's network for at least five years, the carrier cannot fail to renew or terminate the professional's contract unless the carrier provides one year's written notice to the professional and the Commissioner of Banking and Insurance, and the Commissioner finds that the non-renewal or termination is with "good cause." The bill also requires the Commissioner to adopt regulations within 180 days to establish standards for what constitutes "good cause" for the non-renewal or termination of a licensed health care professional.

Committee Categories

Business and Industry

Sponsors (1)

Last Action

Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 01/09/2024)

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