S 627 – New Jersey

Status: Inactive / Dead
Year Introduced: 2020
Link: https://www.njleg.state.nj.us/bills/BillView.asp?BillNumber=S627

Directs State Health Benefits Commission to study reference-based pricing. This bill directs the State Health Benefits Commission (SHBC) to study reference-based pricing. Under the bill, the SHBC will conduct a comprehensive review of reference-based pricing health benefits models and the fiscal impact of implementing reference-based pricing in this State.

The commission is required to evaluate the following, at minimum:

(1) the anticipated costs and savings to the State, to participating employers, and to covered persons associated with implementing reference-based pricing;

(2) the potential effect of reference-based pricing on higher-cost medical services;

(3) the optimal maximum reimbursable amount at which reference-based pricing should be established;

(4) the successes and challenges of reference-based pricing employed in other jurisdictions in the country;

(5) the changes in consumer choice and provider prices and participation before and after implementation of reference-based pricing; and

(6) the requirements and limitations of State and federal law, including the Affordable Care Act, to which the most feasible models would be subject.

The commission will issue a final report on its findings and recommendations, which will include recommendations for legislation, to the Governor and the Legislature by July 1, 2019.

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