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Arbitration Would Be Used to Settle Disputes if New Jersey Insurance Bill Passes

Tuesday, June, 23, 2015


 

New Jersey lawmakers are being encouraged to not let special interests derail legislation that would stop consumers from getting hit with expensive medical bills they did not expect. There is a bill currently before the Senate Commerce Committee that could prevent unexpected medical costs.

 

Currently, patients with medical coverage undergo treatment from their approved primary care doctors, but might also receive care from secondary doctors. For many, this results in costs they were not expecting, which are often several thousand dollars. The bill would require all medical providers to tell patients in advance what the total cost would be and what their insurance company can be expected to cover.


If care were needed in an emergency, the bill requires patients only be charged in-network rates, even if they must receive care from out of network providers. Medical providers can try to get additional money out of the insurance companies and the bill requires these issues be determined through a special arbitration system set up to handle these issues.

 

The bill currently has a great deal of support – from citizens groups, labor unions, and the AARP – but some doctors and hospitals are opposing it. The latter groups are having an effect on lawmakers, too, which could be partly to blame for the bill stalling in the Senate committee.

 

Doctors and hospitals claim the bill reduces their leverage with insurance companies, and will ultimately result in companies not paying as much. Those supporting the bill argue that it could mean less money in the pockets of doctors and hospitals, but the arbitration system would allow them to seek fair reimbursement