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The 'Out-of-Network' Law Enacted in New Jersey

P.L.2018 c.32 titled: 'Out-Of-Network Consumer Protection, Transparency, Cost Containment & Accountability Act' became effective in New Jersey on August 30.

New Jersey Governor Phil Murphy signed the bill in June, after an almost 10 year long struggle that pitted healthcare providers against insurance carriers and the state legislature. Originally conceived as a "surprise medical bill" law, over the years it morphed into what we have today.

"While we look forward to working with the regulatory bodies tasked with promulgating components of this law, we are still disappointed with the enactment of this law in its present somewhat incomplete form," said Jeff Shanton, President NJAASC. "Unfortunately, there are still a lot of moving parts associated with this law, with no guidance from the regulatory bodies that have been tasked under this law to promulgate important components of said law.

"That has made it very difficult to advise not just ASCs, but all healthcare providers about their responsibilities under the law, along with the mandated disclosure of information and the format of said information that they need to have available for the public.

"Without the specifics and guidance from the departments that the law requires them to provide, a void exists that could be misinterpreted by insurance carriers and cause payment issues," continued Mr. Shanton. "While NJAASC has provided a synopsis of the law and bullet points of responsibility for ASCs and professional providers, we have urged that all providers seek legal counsel regarding what they need to do to comply with this law."

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