NJ Passes Healthcare Price Transparency Law to Stop Surprise Bills | RevCycle Intelligence

New Jersey policymakers intend to alleviate the financial burden of surprise medical bills for emergency services by changing provider medical billing practices. For out-of-network services administered on an “emergency or urgent basis,” the law mandates that providers cannot charge in excess of a patient’s deductible, co-payment, or co-insurance amount applicable to in-network services.

Health plans will also face new requirements under the New Jersey law. Payers will have to provide a written notice of network changes, offer detailed information on out-of-network services, and operate a telephone hotline to answer beneficiary questions.

Additionally, policymakers in New Jersey aim to increase healthcare price transparency in the state by requiring providers to give patients healthcare cost estimates upon request. Providers will also have to publicly post standard charges.

The new requirement resembles the recent government push to increase healthcare price transparency. In April 2018, CMS released a proposal that would require hospitals to make a list of their standard charges public on the Internet.

In an exclusive interview with HealthITAnalytics.com, CMS Administrator Seema Verma said the proposal was “just the beginning” of the federal agency’s efforts to increase healthcare price transparency at the provider-level.

“When you go to receive a healthcare service, there are always going to be situations where you can’t know what the costs will be, especially around emergency situations and some acute situations. But for a lot of us, we’re going in for planned procedures. You should be able to know what it’s going to cost you,” she said.

“As people are paying more for their healthcare, they’re demanding more. They want quality and price transparency. This is just a response to the needs of patients,” she continued.

New Jersey and several other states are following in CMS’ lead by offering healthcare price transparency solutions of their own.

Like New Jersey, Colorado also recently passed a law that requires providers to give patients the prices of their most commonly delivered procedures.

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NJ Passes Healthcare Price Transparency Law to Stop Surprise Bills.