Legislation


A 4082 – New Jersey

Status: Inactive / Dead
Year Introduced: 2020
Link: https://www.njleg.state.nj.us/bills/BillView.asp?BillNumber=A4082

Requires DOBI to develop system to require carriers to consult with health care providers on tiered network managed care plans. This bill supplements the “Health Care Quality Act,” to require the Commissioner of Banking and Insurance to develop and maintain a tiered network review system to ensure that a carrier that offers a managed care plan that provides for in-network benefits and for a tiered network shall, prior to offering the plan, consult with health care providers regarding the selection standards used for tier placement in accordance with the provisions of the bill. The bill requires that as part of the tiered network review system the commissioner, in consultation with appropriately qualified health care providers, representatives of the New Jersey Hospital Association, representatives of the New Jersey Medical Society, and members of the public with knowledge and expertise in the provision of health care services, shall arrange for and facilitate panels of health care providers and members of the public to review and provide comments to the carrier on the carrier’s proposed selection standards for placement of health care providers in tiers, for each plan that a carrier proposes to offer. The panels shall be composed, conduct their reviews, and provide comments to carriers in a manner to be determined by the commissioner.


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