New Jersey Archives - Page 5 of 79 - The Source on HealthCare Price and Competition

10 02, 2023

S 1065 (see companion bill A 2789)

In the event that a laboratory that performs an HIV screening test under the bill is out-of-network with respect to a covered person’s health benefits plan, the carrier is to reimburse the laboratory for the cost of the screening test at the carrier’s in-network rate, or in any other reasonable amount as agreed upon by the laboratory and the carrier, less any applicable copayment, coinsurance, or deductible. In no case may a laboratory bill a covered person for the screening test, except for the covered person’s applicable copayment, coinsurance, or deductible.

S 1065 (see companion bill A 2789)

10 02, 2023

A 3595 (see companion bill S 2500)

This bill requires carriers to take certain action to ensure that health benefits plans meet certain network adequacy requirements and mental health care. A plan that provides access to in-network or out-of-network mental health providers that can provide services delivered through telemedicine or telehealth is required to provide coverage for out-of-network mental health care services delivered through telemedicine or telehealth on the same basis as when the services are delivered through in-person contact and consultation in New Jersey and at a provider reimbursement rate of not less than the corresponding Medicaid provider reimbursement rate.

A 3595 (see companion bill S 2500)

10 02, 2023

S 2500 (see companion bill A 3595)

This bill requires carriers to take certain action to ensure that health benefits plans meet certain network adequacy requirements and mental health care. A plan that provides access to in-network or out-of-network mental health providers that can provide services delivered through telemedicine or telehealth is required to provide coverage for out-of-network mental health care services delivered through telemedicine or telehealth on the same basis as when the services are delivered through in-person contact and consultation in New Jersey and at a provider reimbursement rate of not less than the corresponding Medicaid provider reimbursement rate.

S 2500 (see companion bill A 3595)

10 02, 2023

A 4048 (see companion bill S 2535)

The bill provides that if a contract does not have in its network a provider who can provide any part, attachment, or accessory necessary to the continued function of a preexisting cochlear implant, the contract must cover the part, attachment, or accessory when purchased from and provided by an out-of-network provider, and shall only impose cost sharing as if the out-of-network provider were part of the provider network.

A 4048 (see companion bill S 2535)

10 02, 2023

S 2535 (see companion bill A 4048)

The bill provides that if a contract does not have in its network a provider who can provide any part, attachment, or accessory necessary to the continued function of a preexisting cochlear implant, the contract must cover the part, attachment, or accessory when purchased from and provided by an out-of-network provider, and shall only impose cost sharing as if the out-of-network provider were part of the provider network.

S 2535 (see companion bill A 4048)

10 02, 2023

A 4294 (see companion bill S 2824)

The bill removes a provision of law that requires health insurance carriers to offer individual health plans, through the Individual Health Coverage Program, as a condition of participation in the small employer health insurance market. The bill removes a provision of law that requires health insurance carriers that participate in the small employer health insurance market to participate in the Individual Health Coverage Program. The bill also removes a 5-year prohibition on carriers re-entering the individual and small employer health insurance markets if the carrier ceases to offer either plan. The bill modifies the [...]

A 4294 (see companion bill S 2824)

10 02, 2023

S 2824 (see companion bill A 4294)

The bill removes a provision of law that requires health insurance carriers to offer individual health plans, through the Individual Health Coverage Program, as a condition of participation in the small employer health insurance market. The bill removes a provision of law that requires health insurance carriers that participate in the small employer health insurance market to participate in the Individual Health Coverage Program. The bill also removes a 5-year prohibition on carriers re-entering the individual and small employer health insurance markets if the carrier ceases to offer either plan. The bill modifies the [...]

S 2824 (see companion bill A 4294)

10 02, 2023

A 4422

This bill stipulates that the provisions of the "Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act" apply to transportation by emergency medical service helicopter. In addition, the bill establishes a cap of $1,000 on the total amount to be paid by a covered person who receives transportation by emergency medical service helicopter to a health care facility.

A 4422

10 02, 2023

S 1129

Requires certain disclosures to consumers regarding health care costs. This bill, which supplements the “Health Care Quality Act,” requires health care facilities, health care professionals and health insurance carriers to make certain disclosures regarding health insurance network status.

S 1129

10 02, 2023

S 1952

The bill provides that, in the event that a laboratory is out-of-network with respect to an individual’s health benefits plan, the person’s health benefits carrier is to reimburse the laboratory at the carrier’s in-network rate, or in any other reasonable amount as agreed upon by the laboratory and the carrier, less any applicable copayment, coinsurance, or deductible, and the laboratory will be prohibited from billing the covered person for the screening test, other than for the applicable copayment, coinsurance, or deductible. This prohibition will not apply in situations in which: (1) the laboratory checks [...]

S 1952