S 195 – New Jersey

Status: In Process
Year Introduced: 2022
Link: https://www.njleg.state.nj.us/bill-search/2022/S195

Allows physicians to jointly negotiate with carriers over contractual terms and conditions. This bill provides physicians with the right to engage in joint negotiations over the terms and conditions of their contracts with health insurance carriers, that is, health, hospital and medical service corporations, commercial health insurers, and health maintenance organizations. The bill is based on legislation enacted in 2002 (P.L.2001, c.371) that authorized physicians and dentists to engage in joint negotiations with carriers, which legislation expired in 2008.

The bill permits two or more independent physicians who are practicing in the geographic service area of a carrier to jointly negotiate with the carrier and engage in related joint activity over the terms and conditions of a proposed contract. The negotiations would be carried out through a joint negotiation representative selected by the physicians to act on their behalf. In addition, the bill provides that a proposed contract concerning fees and fee-related matters may be subject to joint negotiations if the Attorney General, in consultation with the Commissioner of Banking and Insurance, finds that the carrier has substantial market power in its service area and that any of the terms or conditions of the contract with the carrier pose an actual or potential threat to the quality and availability of patient care among covered persons.

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