Legislation


A 2039 (see companion bill S 485) – New Jersey

Status: Enacted
Year Introduced: 2018
Link: http://www.njleg.state.nj.us/2018/Bills/A2500/2039_I1.HTM

OUT OF NETWORK CONSUMER PROTECTION, TRANSPARENCY, COST CONTAINMENT AND ACCOUNTABILITY ACT: a health care facility is required to: (1) disclose whether the health care facility is in-network or out-of-network with respect to the covered person’s health benefits plan; and (2) advise the covered person to check with the physician arranging the facility services to determine whether or not that physician is in-network or out-of-network with respect to the covered person’s health benefits plan and provide information about how to determine the health plans participated in by any physician reasonably anticipated to provider services. Payer must ensure that a covered person who went to an in network facility and incurred out of network charges would not pay more than what they would have paid in network. Establish arbitration mechanism.


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