Bill > A1862

Introduced Session

This bill supplements the "Health Care Quality Act," P.L.1997, c.192 (C.26:2S-1 et seq.) to provide that, when a covered person is receiving post-operative follow-up care, follow-up care for the treatment of a diagnosed illness or condition, or other follow-up care for any other covered service, which follow-up care is provided by a participating provider, the covered person shall be responsible for the payment of only one co-payment or deductible to the participating provider under the plan during any period of 180 days following the payment of that co-payment or deductible. The bill further prohibits the participating provider from collecting more than one such co-payment or deductible, during any period of 180 days following the payment of that co-payment or deductible, regardless of the number of follow-up care visits during that period. The provisions of the bill would only apply if the covered person complies with the preauthorization or review requirements of the health benefits plan regarding the determination of medical necessity to access in-network inpatient benefits.

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Committee Categories

Benjie Wimberly (D)*,  Greg McGuckin (R),  Sheila Oliver (D),  Vincent Prieto (D),  L. Grace Spencer (D),  Cleopatra Tucker (D), 

Assembly Financial Institutions and Insurance Hearing (10:00 9/22/2016 Committee Room 16, Fourth Floor) (on 09/22/2016)