New Jersey Assembly Bill A1452

New Jersey 2024-2025 Regular Session

• Introduced: 1/9/24
• Refer: 1/9/24

Caption

Concerns standards for non-renewal or termination of certain health care professionals from insurance carrier's provider network.

Impact

The passing of A1452 is expected to have significant implications for state laws governing managed care. It will amend existing regulations by ensuring that health care professionals are not removed from provider networks without a fair opportunity for notice and due process. The Commissioner of Banking and Insurance will be tasked with establishing regulations that define 'good cause' for non-renewal or termination and will do so within 180 days of the bill's enactment.

Summary

Assembly Bill A1452 seeks to establish standardized policies regarding the non-renewal or termination of health care professionals within insurance carriers' provider networks. It aims to protect licensed health care professionals, particularly those who have been part of a carrier's network for five years or longer, from abrupt contract terminations without adequate notice. Specifically, the bill mandates that carriers must provide a written notice of intent not to renew or terminate a contract at least one year prior to the effective date of such actions, along with documentation of the reasons for those decisions.

Contention

While the bill is largely aimed at enhancing protections for health care professionals, it is possible that it may face opposition from insurance carriers concerned about the potential constraints on their flexibility in managing provider networks. Proponents argue that such protections are necessary to maintain a stable health care workforce and to ensure continuity of care for patients. However, skeptics might contend that the regulations could complicate operational decisions for insurance providers and possibly lead to unintended consequences in the health care sector.