Legislation


A 1870 – New Jersey

Status: Inactive / Dead
Year Introduced: 2018
Link: https://www.njleg.state.nj.us/bills/BillView.asp?BillNumber=A1870

ESTABLISHES CERTAIN NETWORK ADEQUACY AND STANDARD APPLICATION REQUIREMENTS FOR HEALTH INSURANCE CARRIERS; REQUIRES DETERMINATION OF HOSPITAL DIVERSITY FOR TIERED NETWORKS. The bill prohibits the commissioner from issuing conditional approvals of provider network adequacy. Carriers must demonstrate that the provider network or, in the case of a tiered network, each tier of the tiered network, meets all requirements for network adequacy before network adequacy is approved, including having the necessary contracts in place at the time of approval. In the case of a tiered network, the commissioner must make a determination that each tier of the network includes a diversity of hospitals located throughout the State, including hospitals which provide significant levels of care to low-income, uninsured, and vulnerable populations, to assure that the tiered network does not discriminate against underserved or high-risk populations.


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