Bill
Bill > A5029
summary
Introduced
11/14/2024
11/14/2024
In Committee
11/14/2024
11/14/2024
Crossed Over
Passed
Dead
01/12/2026
01/12/2026
Introduced Session
2024-2025 Regular Session
Bill Summary
This bill prohibits health care providers from billing patients for services provided under the early intervention services program more than one year after the service was provided, and prohibits providers from attempting to collect from a patient on a bill for early intervention services if the bill was issued more than one year after the service was provided. Nothing in the bill will prohibit a health care provider from, at any time, seeking reimbursement for the service from the patient's health benefits plan; provided that, if the health benefits plan denies the claim or provides only partial reimbursement, the health care provider will be prohibited from billing the patient for the balance of the claim if: 1) the claim was submitted to the health benefits plan more than one year after the date the service was provided; or 2) the claim was submitted to the plan within one year from the date the service was provided, but more than 18 months elapsed since the date the service was provided. The early intervention services program is a Statewide program that provides specialized services and supports, from birth through age two, to infants and toddlers experiencing physical, cognitive, communication, social, emotional, or adaptive developmental delays or disabilities. It has been suggested that some early intervention services providers have issued bills to patients years after the early intervention service was originally provided. This practice can result in administrative headaches and affordability issues for parents who are already navigating the complexities of caring for a child with special needs, as the parent then needs to negotiate with an insurance provider or find the money to cover the bill long after the child has exited the early intervention services program. It is the sponsor's intent to help these families avoid the burden of these unexpected medical bills.
AI Summary
This bill restricts billing practices for early intervention services, which are specialized supports for infants and toddlers with developmental delays or disabilities. Specifically, the bill prohibits health care providers (defined as health care facilities or professionals) from issuing bills to patients more than one year after services were provided or attempting to collect payment on such delayed bills. The bill still allows providers to seek reimbursement from a patient's health benefits plan at any time, but places limitations on patient billing if the insurance claim is submitted late. If an insurance plan denies a claim or provides partial reimbursement, the provider cannot bill the patient for the remaining balance if: (1) the claim was submitted to the health plan more than one year after service, or (2) the claim was submitted within one year but more than 18 months have elapsed since the original service date. The goal of the bill is to protect families with children in the early intervention program from unexpected and burdensome medical bills years after services were rendered, reducing administrative challenges and financial strain for parents already managing the complexities of caring for a child with special needs.
Committee Categories
Business and Industry
Sponsors (1)
Last Action
Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 11/14/2024)
Official Document
bill text
bill summary
Loading...
bill summary
Loading...
bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.njleg.state.nj.us/bill-search/2024/A5029 |
| BillText | https://pub.njleg.gov/Bills/2024/A5500/5029_I1.HTM |
Loading...