Progress on New Jersey’s Out-of-Network Healthcare Provider Bill, which would have protected consumers from hidden costs, was stalled at a Senate Commerce Committee hearing on Thursday, December 10th. Both the New Jersey Hospital Association and the Medical Society of New Jersey mounted fierce opposition to the bill in its current form which some believe resulted in the Senate Commerce Committee’s response.

 Unless the bill is promulgated into law, there is still a risk that New Jersey consumers bear the cost of out-of-network provider and lab fees while being treated at in-network hospitals. Two of the most common hidden providers are anesthesiologists or radiologists, whose services are integral to both in and out-patient surgical procedures and lab testing.

 On the other hand, New York consumers are protected from surprise bills when services are performed by a non-participating (out-of-network) doctor at a participating hospital or ambulatory surgical center in an HMO or an insurer’s network or when a participating doctor refers an insured to a non-participating provider. New York law also protects consumers from bills for emergency services.

 Whether New Jersey will follow New York’s lead with respect to protection of consumers from hidden provider fees remains to be seen.


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