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Bill > A1962


NJ A1962

NJ A1962
Establishes cap on amount that hospital can charge patients for laboratory services to 150% of Medicare.


summary

Introduced
01/13/2026
In Committee
01/13/2026
Crossed Over
Passed
Dead

Introduced Session

2026-2027 Regular Session

Bill Summary

This bill would prohibit a hospital from billing certain patients for laboratory services in an amount that exceeds 150% of the applicable payment rate under the federal Medicare program. Under existing law, at P.L.2008, c.60 (C.26:2H-12.52 et seq.), whenever a hospital provides health care services (including laboratory services) to an uninsured patient whose family gross income is less than 500% of the federal poverty level, the hospital is prohibited from charging the patient more than 115% of the applicable payment rate for those services under the federal Medicare program. This bill would establish a similar cap on charges for laboratory services that are provided to patients who do not satisfy the income and other requirements of P.L.2008, c.60. In particular, the bill would provide that, except in cases where the provisions of P.L.2008, c.60 are applicable, a hospital will be prohibited from charging a patient in this State more than 150% of the applicable payment rate under the federal Medicare program for any laboratory services that are rendered to the patient. The existing 115% cap established under P.L.2008, c.60 would still be applicable to laboratory and other health care services that are provided by a hospital to uninsured persons who satisfy the applicable income requirements.

AI Summary

This bill establishes a new cap on the amount hospitals can charge patients for laboratory services, limiting it to 150% of the rate paid by Medicare, the federal health insurance program for seniors and some disabled individuals. This new cap applies to most patients, but it does not override existing protections under a 2008 law (P.L.2008, c.60) which already limits charges to 115% of the Medicare rate for uninsured patients whose family income is below 500% of the federal poverty level. In essence, this bill extends a similar cost control measure to a broader group of patients for laboratory tests, while preserving the existing, more stringent cap for low-income uninsured individuals.

Sponsors (1)

Last Action

Introduced, Referred to Assembly Health Infrastructure Committee (on 01/13/2026)

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