A 4761 (see companion bill S 3201) – New Jersey

Status: Inactive / Dead
Year Introduced: 2018
Link: https://www.njleg.state.nj.us/bills/BillView.asp?BillNumber=A4761

REVISES CERTAIN ASPECTS OF OUT-OF-NETWORK ARBITRATION PROCESS UNDER THE “OUT-OF-NETWORK CONSUMER PROTECTION, TRANSPARENCY, COST CONTAINMENT AND ACCOUNTABILITY ACT.” The act establishes an arbitration system for out-of-network health care services provided in certain emergency and inadvertent situations that result in payment disputes between health insurance carriers and health care providers. The bill also requires a carrier to pay the provider the billed amount, or pay at least the amount set by the 85th percentile of the FAIR Health Charge Benchmark database for the particular health care service performed by a provider in the same or similar specialty and provided in the same geographical area, which shall be deemed the carrier’s final offer for purposes of the act.


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