NJ A3043

Bill

Requires medical fee schedule by automobile insurers to provide for reimbursement of certain services provided by ambulatory surgical center at rate of 300 percent of Medicare payment rate.

Introduced
01/13/2026

In Committee
01/13/2026

Crossed Over

Passed

Dead

Introduced Session

2026-2027 Regular Session

Bill Summary

This bill requires the medical fee schedule promulgated by the Commissioner of Banking and Insurance that is used for the reimbursement of medical expenses by certain automobile insurers to provide for reimbursement of services provided by an ambulatory surgical center that are not currently listed on the medical fee schedule at a rate of 300 percent of the Medicare payment rate for that service provided that the services are reimbursable pursuant to current Centers for Medicare and Medicaid Services guidelines. Unlisted medical supplies utilized in conjunction with services that are not currently listed on the medical fee schedule are required to be reimbursed at invoice cost plus 20 percent.

AI Summary

This bill mandates that the medical fee schedule, which automobile insurers use to reimburse medical expenses, must provide for ambulatory surgical centers (ASCs) to be reimbursed at 300% of the Medicare payment rate for services not currently listed on the schedule, provided these services are reimbursable under current Centers for Medicare and Medicaid Services (CMS) guidelines. CMS is a federal agency that administers Medicare and Medicaid. Additionally, unlisted medical supplies used with these unlisted services will be reimbursed at their invoice cost plus a 20% markup. This change aims to ensure fair compensation for ASCs and associated supplies within the context of automobile insurance personal injury protection (PIP) coverage and other relevant medical expense benefits.

Committee Categories

Business and Industry

Sponsors (1)

Chris Tully (D)*,

Last Action

Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 01/13/2026)

Official Document

https://www.njleg.state.nj.us/bill-search/2026/A3043

(3 Companion Bills)

Version:

Document Type	Source Location
State Bill Page	https://www.njleg.state.nj.us/bill-search/2026/A3043
BillText	https://pub.njleg.gov/Bills/2026/A3500/3043_I1.HTM

Bill	Bill Name	Last Action	Type
A2349	Requires medical fee schedule by automobile insurers to provide for reimbursement of certain services provided by ambulatory surgical center at rate of 300 percent of Medicare payment rate.	Introduced, Referred to Assembly Financial Institutions and Insurance Committee	Carry Over
S1373	Requires medical fee schedule by automobile insurers to provide for reimbursement of certain services provided by ambulatory surgical center at rate of 300 percent of Medicare payment rate.	Introduced in the Senate, Referred to Senate Commerce Committee	Same As
S1464	Requires medical fee schedule by automobile insurers to provide for reimbursement of certain services provided by ambulatory surgical center at rate of 300 percent of Medicare payment rate.	Introduced in the Senate, Referred to Senate Commerce Committee	Carry Over

Bill > A3043

summary

Introduced Session

Bill Summary

AI Summary

Committee Categories

Sponsors (1)

Last Action

Official Document

bill text

bill summary

bill summary

bill summary