New Jersey Assembly Bill A3950

New Jersey 2022-2023 Regular Session

• Introduced: 5/12/22
• Refer: 5/12/22

Caption

Establishes cap on amount that hospital can charge patients for laboratory services to 150% of Medicare.

Impact

The passage of A3950 will harmonize hospital billing practices for laboratory services with federal Medicare benchmarks. Currently, under existing law P.L.2008, c.60, uninsured patients with family incomes below a certain threshold are already protected by a more stringent cap of 115% of Medicare rates for various healthcare services. A3950 extends similar protection to a broader group of patients by ensuring that no hospital can charge more than 150% of the Medicare rate for laboratory services unless they qualify for the existing protections. This may lead to more predictable healthcare costs for patients and less financial strain for those facing medical bills.

Summary

Assembly Bill A3950 aims to cap the amount that hospitals can charge patients for laboratory services, establishing a limit of 150% of the applicable payment rate under the federal Medicare program. This legislation is designed to provide some financial relief to patients who receive laboratory services while aiming to ensure more equitable healthcare costs across New Jersey. The bill would directly impact patients who might otherwise face exorbitant billing practices from hospitals, particularly those who are uninsured or do not fit specific income requirements under existing legislation.

Contention

Critically, while the bill aims to protect patients from high costs, there may be concerns regarding the implications for hospitals’ revenue, particularly smaller or underfunded facilities that rely on higher billing rates to subsidize service provisions. Additionally, some stakeholders might view this legislation as an insufficient measure for more comprehensive healthcare reform, arguing that it does not address systemic issues surrounding healthcare access and affordability. The balance between ensuring hospital viability and protecting patients' financial interests will likely be a focal point of discussion among legislators as the bill progresses.