Legislation

N.J. Admin Code 11:24C-4.3 – New Jersey

Status: Enacted
Link: https://web.lexisnexis.com/research/retrieve?_m=ea5492fba14e04577c54a81045180c26&displacement=0&oldFmt=FULL&oldAlias=%a7%26nbsp%3b11%3a24C-4.3%26nbsp%3bProvider%20agreements&oldtcsvrnid=TAAPABFAAFAAD&_fmtstr=BOOK&alias=&_stateList=alias&docnum=1&_startdoc=1&wchp=dGLzVzk-zSkAz&_md5=60741eeffbe47278074ff8389ab17ea2

Prohibits most favored nation clauses, or clauses having a similar effect, in an agreement between an insurance carrier and a participating provider. A most favored nations clause is an agreement between a payer (such as an insurance company) and a provider that typically requires a provider to give the payer the lowest rate that it gave to any other comparable payer, which can be anticompetitive by encouraging oligopolistic pricing by large payers and increasing barriers for new entrants. Agreements between a participating provider and a carrier are not subject to the prior approval of the Commissioner.


Associated Litigation:

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