Here’s what you should know:
1. The proposal would apply only to bills generated through emergency or inadvertent situations, and both situations require physicians and payers to be transparent about what services are covered by a patient’s insurance. The proposal would also attempt to regulate out-of-network charges through the use of a state-appointed arbitrator, who would choose between offers from payers and providers.
2. New Jersey Governor Phil Murphy, D, and New Jersey assembly leadership support the bill.
3. Providers are fearful the proposal will put physicians at a disadvantage when it comes to contract negotiations. They fear without the threat of high out-of-network charges, providers will have limited leverage when crafting in-network agreements.
4. The N.J. assembly’s Financial Institutions and Insurance Committee had a four-hour discussion of the bill Feb. 5.
5. The Medical Society of New Jersey believes the proposal is overstated, and that changes in insurance contracting and state oversight are attempting to corral the problem from within. The group feels legislation isn’t needed to discipline the “bad actors.”
6. Assemblyman Gary Schaer, D-Bergen, said, “This is not a perfect bill, but it seems to me this is a very significant best effort to find a solution to a problem that everyone seems to agree there is.”
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