Bill > A4444

This bill, known as the "Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act," aims to reform New Jersey's healthcare system by increasing transparency, protecting consumers from surprise medical bills, and controlling costs. Key provisions include requiring healthcare facilities and professionals to provide clear written disclosures about network status and estimated costs for non-emergency procedures, and mandating that carriers (insurance companies and similar entities) provide accessible information about in-network providers. The bill establishes a Healthcare Price Index (HPI) to collect and analyze health care data, which will be used to determine a payment range for out-of-network emergency or inadvertent services, thereby limiting patient out-of-pocket expenses to what they would pay for in-network care. If a carrier and an out-of-network provider cannot agree on a reimbursement rate within 30 days, the dispute will be resolved through binding arbitration. The bill also mandates public reporting of arbitration data, network status, and other relevant healthcare cost and utilization information to promote informed decision-making by consumers, policymakers, and providers.