Government

Murphy Signs Bill Into Law For Those Screwed By Health Costs | More administrative costs; just what the doctor ordered😷🤒🤕

This is about New Jersey, but the concept applies everywhere.

If there ever was an example of bureaucratic stupidity mixed with political incompetence this is it. Note in the quote below that the problem of out-of-network balance billing is particularly associated with emergency care. Then note the main requirements of the bill apply prior to “non-emergency care.”

Murphy signed legislation that is designed to protect you from getting hit with those surprise out-of-network medical bills that seem to show up when you go to the doctor for even the smallest ailment. Or, as Murphy put it, the legislation is for those tens of thousands of New Jerseyans each year who are “getting screwed” by surprise medical costs – particularly when they’re dealing with emergency care.

Source: Murphy Signs Bill Into Law For Those Screwed By Health Costs | Point Pleasant, NJ Patch

Just what we need, more bureaucracy and administration placed on health care providers … more costs for patients. And all this pretty much accomplishes nothing. Think anesthesiologist or radiologist; the two most common incidences of balance billing. And if all this applies to non-emergency health care, what is stopping the patient from simply asking if a provider participates in their plan?

Balance billing can be a problem in some instances and that could be solved just as Medicare does; limit billing by non-participating providers to 115% (or other percent) of the participating provider allowed fee. Instead NJ creates more administrative costs. Bazinga‼️

Here is a summary of the requirements of the legislation excerpted from the above article.

The bill requires health care facilities, prior to non-emergency or elective procedures, to:

• disclose to patients whether the health care facility is in-network or out-of-network in respect to the patient’s health benefits plan;

• advise patients that, if the facility is in-network, the patient will not incur any out-of-pocket costs outside of those typically applicable to an in-network procedure unless he or she has knowingly, voluntarily, and specifically selected an out-of-network provider to provide services;

• inform patients that, if the facility is out-of-network, the patient will have a financial responsibility applicable to health care services provided at an out-of-network facility.

In addition, health care facilities will be required to make available to the public a list of the facility’s standard charges for items and services it provides.

The bill will also require health care professionals, verbally or through a website, to disclose to covered patients the health benefits plans in which they are participating providers as well as the facilities with which they are affiliated, prior to non-emergency services at the time of an appointment.

If the health care professional is out-of-network, the bill also requires health care professionals to:

• inform patients that they are out-of-network and that the estimated amount to be billed for services is available upon request;

• disclose to patients, in writing if requested, the amount the health care professional will bill absent of unforeseen medical circumstances that may arise when the medical service is provided; and

• advise patients that they will have a financial responsibility applicable to health care services provided by an out-of-network professional in excess of their copayment, deductible, or coinsurance, and that they may be responsible for any costs in excess of those allowed by their health benefits plan.

The bill also places the responsibility on health care professionals to provide to patients, as practicable, contact information of any health care providers scheduled to perform anesthesiology, lab, pathology, radiology or assistant surgeon services in connection with the care to be provided, and to recommend that the patient contact their carrier to learn more about any costs associated with these services.

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2 replies »

  1. New Jersey and Washington State where I live are both blue states with a lot in common. But one of them is not gun law. Washington allows open carry and concealed carry of weapons which are very easy to obtain. I guess it’s an historical orphan carry over from the early wild west days.

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  2. I assume that this will only apply to in state billing, considering that most out of state is out-of-network to most plans.

    And no, bureaucratic stupidity mixed with political incompetence is at an all time high in Trenton. You should see the stupidity in the new guns laws. You have 180 days to modify “high capacity magazines” to 10 rounds or less, or turn them in BUT it is illegal to destroy them, sell them out of state, or transport them to turn them in without compensation, even during the 180 day grace period (roughly re-stated). Thousands of New Jerseys just became felons with a stroke of a pen overnight on June 13, 2018. Now it does not matter where you stand on the 2nd Amendment issues but this is just another example of bad governing and regulations. A regulation that traps you no matter what you do to comply.

    I just can’t imagine what other crap Trenton and Washington are pushing out without me even knowing about it which only causes costs to rise trying to comply. You should not need a law degree and a full time staff of law clerks to live your life. (For the record, two lawyers friends are scratching their heads on how to comply too.)

    Sorry for the side rant but I am surprised that we do not have TV commercials for patient advocates to help get your claims paid like the social security lawyer commercials or to stop collections for said out-of-network services. It could be another scam against senior citizens.

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