S 3622 (see companion bill A 1854) – New Jersey

Status: Inactive / Dead
Year Introduced: 2020
Link: https://www.njleg.state.nj.us/bills/BillView.asp?BillNumber=S3622

Requires insurers to reimburse for medically necessary emergency and urgent care health care services in outpatient settings. This bill provides that, in the case of a request for authorization for a covered person who is currently receiving emergency or urgent health care services in an outpatient or other setting, including a physician’s office, the payer shall communicate the denial of the request or the limitation imposed on the requested service to the hospital or physician within a time frame appropriate to the medical exigencies of the case but no later than 24 hours following the time the request was made.

The bill also provides that the current requirement that a health insurance carrier shall reimburse a hospital or physician according to the provider contract for all medically necessary emergency and urgent care health care services that are covered under the health benefits plan, including all tests necessary to determine the nature of an illness or injury applies regardless whether the services are provided in an emergency room or other facility, or in an outpatient setting, such as a physician’s office.

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