Bill Text: NJ A1450 | 2024-2025 | Regular Session | Introduced
Bill Title: Concerns carrier networks and health care providers in which carrier has financial interest.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced) 2024-01-09 - Introduced, Referred to Assembly Financial Institutions and Insurance Committee [A1450 Detail]
Download: New_Jersey-2024-A1450-Introduced.html
STATE OF NEW JERSEY
221st LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2024 SESSION
Sponsored by:
Assemblyman ROBERT J. KARABINCHAK
District 18 (Middlesex)
SYNOPSIS
Concerns carrier networks and health care providers in which carrier has financial interest.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel.
An Act concerning carrier networks and supplementing P.L.1997, c.192 (C.26:2S-1 et seq.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. Pursuant to section 19 of P.L.1997, c.192 (C.26:2S-18), the commissioner shall only approve the network adequacy of a managed care plan if the carrier has demonstrated, to the commissioner's satisfaction, that the provider network meets all network adequacy requirements without considering any health care provider that the carrier has a financial interest in.
b. As used in this section, "financial interest" means:
(1) holding a position in a business as officer, director, trustee, or partner, or holding any position in management of the business, except that any position-holder in a non-profit organization who is not compensated for holding that position shall not be considered to have a financial interest in the organization; or
(2) ownership of more than a five percent interest in a business, or ownership of a carrier and a health care provider by the same parent company.
2. This act shall take effect on the 90th day next following enactment.
STATEMENT
This bill provides that the Commissioner of Banking and Insurance shall only approve the network adequacy of a managed care plan if the carrier has demonstrated, to the commissioner's satisfaction, that the provider network meets all network adequacy requirements without considering any health care provider that the carrier has a financial interest in.
As used in the bill, "financial interest" means:
(1) holding a position in a business as officer, director, trustee, or partner, or holding any position in management of the business, except that any position-holder in a non-profit organization who is not compensated for holding that position shall not be considered to have a financial interest in the organization; or
(2) ownership of more than a five percent interest in a business, or ownership of a carrier and a health care provider by the same parent company.
