New Jersey Proposes to Limit How Much Physicians, ASCs Charge for Outpatient Care

A New Jersey proposal would instate approximately 1,000 price codes controlling how much physicians, surgery centers and hospitals can charge for outpatient treatments for auto accidents, while abolishing another 117 price controls due to physician backlash, according to an NJ.com report.

The price control policy came after officials stressed that personal injury protection, better known as PIP, is rife with abuse due to physicians and hospitals submitting inflated bills for procedures.

Banking and Insurance Commissioner Thomas Considine responded to the outrage by introducing a list of tough rules to crack down on suspected PIP fraud. But physicians fought back: Neurosurgeons, spine surgeons and anesthesiologists flooded the insurance department's mailbox with letters stating that physicians would stop treating auto accident victims if the state limited charges for pain management treatments.

Surgeons also contributed up to $76,500 to the Republican State Committee. In response to an onslaught of comments, state insurance officials deleted proposed price controls on 117 back and spinal outpatient procedures.

State officials say the proposal will help to regulate the $1.1 billion auto insurance market for medical costs. Surgery center operators and physicians say the proposal gives insurers too much power to deny necessary treatment. The proposal would instate approximately 1,000 price codes controlling how much physicians, ASCs and hospitals can charge for outpatient treatments.

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