Bill Text: NJ A4554 | 2018-2019 | Regular Session | Introduced
Bill Title: Requires filing of certain findings on out-of-network arbitrations and requires Commissioner of Banking and Insurance to conduct surveys and produce certain reports.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2018-10-15 - Introduced, Referred to Assembly Financial Institutions and Insurance Committee [A4554 Detail]
Download: New_Jersey-2018-A4554-Introduced.html
Sponsored by:
Assemblyman RAJ MUKHERJI
District 33 (Hudson)
SYNOPSIS
Requires filing of certain findings on out-of-network arbitrations and requires Commissioner of Banking and Insurance to conduct surveys and produce certain reports.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning health insurance and arbitration and supplementing P.L.2018, c.32 (C.26:2SS-1 et seq.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. Any entities under contract with by the Department of Banking and Insurance pursuant to paragraph (3) of subsection b. of section 10 of P.L.2018, c.32 (C.26:2SS-10) shall file the written findings of any arbitration with the Commissioner of Banking and Insurance, who shall establish a record of the proceedings conducted under the arbitration. The name of any injured party shall be redacted in the copy filed with the commissioner to protect the privacy of the injured person.
b. (1) Beginning with the receipt of the first written findings by the commissioner and continuing for a period of 90 days, the commissioner shall conduct a survey of the parties to any arbitrations for which the commissioner receives written findings. The survey shall elicit participants' feedback on the arbitration process with the aim of making improvements to the process.
(2) The commissioner shall analyze the written findings and surveys during that 90 day period and produce a report detailing her findings and recommendations concerning the arbitration process, to be delivered to the Governor and Legislature within 120 days of the receipt of the first written findings by the commissioner. The commissioner shall consider and include a summary of the survey information in her findings and recommendations. The survey information included in the report shall not include any information specifically identifying the provider, carrier, or covered person involved in any arbitration decision. The report shall include an examination of the arbitration results as compared to national data, such as the data included in the FAIR Health Database and similar criteria of usual and customary reimbursement amounts.
c. After the first report is delivered to the Governor and Legislature, the commissioner shall produce reports every two years analyzing any written findings filed with the commissioner pursuant to this act. The commissioner may contract with the entities contracted with pursuant to paragraph (3) of subsection b. of section 10 of P.L.2018, c.32 (C.26:2SS-10) to satisfy the provisions of this subsection.
2. This act shall take effect immediately.
STATEMENT
This bill requires the filing of certain findings on out-of-network arbitrations and requires the Commissioner of Banking and Insurance to conduct surveys and produce certain reports.
Specifically, the bill requires any entities contracted with by the Commissioner of Banking and Insurance to conduct arbitrations pursuant to the "Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act," P.L.2018, c.32, to file with the commissioner the written findings of any arbitrations. The bill requires the commissioner to establish a record of the proceedings conducted under those arbitrations. The name of any injured party is required to be redacted in the copy filed with the commissioner to protect the privacy of the injured person.
Beginning with the receipt of the first written findings by the commissioner and continuing for a period of 90 days, the commissioner is required to conduct a survey of the parties to any arbitration for which the commissioner receives written findings. The survey is to elicit participants' feedback on the arbitration process with the aim of making improvements to the process.
The bill requires the commissioner to analyze the written findings and surveys during that 90 day period and produce a report detailing her findings and recommendations concerning the arbitration process, to be delivered to the Governor and Legislature within 120 days of the receipt of the first written findings by the commissioner. The survey information included in the report is not to include any information specifically identifying the provider, carrier, or covered person involved in any arbitration decision. The report must include an examination of the arbitration results as compared to national data, such as the data included in the FAIR Health Database and similar criteria of usual and customary reimbursement amounts.
The bill also provides that after the first report is delivered to the Governor and Legislature, the commissioner must produce reports every two years analyzing any written findings filed with the commissioner. The commissioner may contract with the entities contracted with pursuant to the "Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act," P.L.2018, c.32, to satisfy this requirement.
