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Bill > A1124


NJ A1124

NJ A1124
Permits payment of only one co-payment or deductible for follow-up care or treatment after surgery or illness under certain health benefits plans.


summary

Introduced
01/09/2018
In Committee
01/09/2018
Crossed Over
Passed
Dead
01/08/2020

Introduced Session

2018-2019 Regular Session

Bill Summary

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.

AI Summary

This bill supplements the "Health Care Quality Act" to provide that when a covered person is receiving post-operative follow-up care, follow-up care for a diagnosed illness or condition, or other follow-up care from a participating provider, the covered person shall only be responsible for one co-payment or deductible within a 180-day period. The bill also prohibits the participating provider from collecting more than one co-payment or deductible during that 180-day period, regardless of the number of follow-up visits. These provisions would only apply if the covered person complies with the plan's preauthorization or review requirements for accessing in-network inpatient benefits.

Committee Categories

Business and Industry

Sponsors (4)

Last Action

Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 01/09/2018)

bill text


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