In the 2018 legislative session, New Jersey passed the Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act (A 2039/S 485), which protects patients from surprise out-of-network medical bills. Among other mandates, providers would have to tell their patients before scheduling an appointment whether the provider is in or out of the person’s insurance network, as well as disclose all the financial liability the patient is likely to have for the given procedure. The measure also puts robust reporting and transparency requirements on carriers.
The state also introduced a number of bills aimed at increasing insurance and prescription cost transparency in the current session, with more likely to come.
The State Database
The Source tracks state activities impacting healthcare price and competition in both legislation and litigation in a searchable database to help stakeholders at the state level understand their legal and regulatory environment as they make efforts to improve access, quality, and efficiency, and reduce costs in healthcare.
LEGISLATION: The Database of State Laws Impacting Healthcare Cost and Quality (SLIHCQ), created by The Source on Healthcare Price & Competition and Catalyst for Payment Reform, catalogues state legislation governing price transparency, provider market power, provider payment, provider networks, and benefit design. The database also includes pharmaceutical legislation beginning in the 2017-2018 legislative session. *Note: Current legislative session bill updates are ongoing. Check back weekly for updates.
LITIGATION: The Source tracks major litigation and antitrust enforcement action by federal entities (FTC or DOJ), state attorney generals, and private parties in the main provider and insurer markets, particularly legal challenges of healthcare consolidation and anticompetitive contract provisions. Additionally, the database contains major pharmaceutical cases including legislation challenges and significant appellate cases.
Search the database across all jurisdictions on the State Overview page, or view and filter existing legislation or litigation on individual state pages. The database allows customized search and filter by keyword, status, and/or key issue category. *Multiple filter/selections enabled. Click here for User Guide.