New Jersey 2024-2025 Regular Session

New Jersey Senate Bill S1464

Introduced
1/9/24  

Caption

Requires medical fee schedule by automobile insurers to provide for reimbursement of certain services provided by ambulatory surgical center at rate of 300 percent of Medicare payment rate.

Impact

The implementation of S1464 is expected to have a significant impact on state insurance regulations, particularly in how medical expenses related to automobile accidents are managed. By mandating higher reimbursement rates for ASCs, the bill aims to enhance healthcare access for injured individuals needing outpatient surgical procedures. It may also help to alleviate the financial strain on these centers, encouraging more facilities to provide necessary services, which could improve overall patient outcomes in motor vehicle accident cases.

Summary

Senate Bill S1464 aims to amend the medical fee schedule used by automobile insurers in the state of New Jersey. Specifically, it requires that these insurers provide reimbursement for certain services offered by ambulatory surgical centers (ASCs) at a rate set at 300 percent of the Medicare payment rate. This change is intended to ensure that services from ASCs, which are often not adequately reimbursed under current insurance practices, receive fair compensation comparable to federal Medicare rates. The bill also stipulates that reimbursement for unlisted medical supplies used in conjunction with these services will be capped at invoice cost plus 20 percent.

Contention

While the bill has been designed to support ambulatory surgical centers and their patients, it could also raise concerns among insurance companies regarding increased costs. Opponents may argue that setting a high reimbursement rate could lead to higher premiums for policyholders. Moreover, this legislative change may open debates about the adequacy of reimbursement rates for services rendered and the potential consequences for insurance companies in maintaining service affordability. Therefore, discussions around this bill could involve a balancing act between ensuring adequate healthcare access and managing insurance costs.

Companion Bills

NJ A2349

Same As Requires medical fee schedule by automobile insurers to provide for reimbursement of certain services provided by ambulatory surgical center at rate of 300 percent of Medicare payment rate.

NJ S2392

Carry Over Requires medical fee schedule by automobile insurers to provide for reimbursement of certain services provided by ambulatory surgical center at rate of 300 percent of Medicare payment rate.

NJ A4057

Carry Over Requires medical fee schedule by automobile insurers to provide for reimbursement of certain services provided by ambulatory surgical center at rate of 300 percent of Medicare payment rate.

Previously Filed As

NJ S2392

Requires medical fee schedule by automobile insurers to provide for reimbursement of certain services provided by ambulatory surgical center at rate of 300 percent of Medicare payment rate.

NJ A4057

Requires medical fee schedule by automobile insurers to provide for reimbursement of certain services provided by ambulatory surgical center at rate of 300 percent of Medicare payment rate.

NJ A2349

Requires medical fee schedule by automobile insurers to provide for reimbursement of certain services provided by ambulatory surgical center at rate of 300 percent of Medicare payment rate.

NJ S737

Medicaid Rates/Ambulatory Surgical Centers

NJ H229

Medicaid Rates/Ambulatory Surgical Centers

NJ AB3083

Ambulatory surgical centers.

NJ AB370

Ambulatory surgical centers.

NJ HB454

Medicaid; increase reimbursement rate for providers of assisted living services.

NJ H0475

Ambulatory Surgical Centers

NJ HB1206

Reimbursement of ambulatory surgical centers.

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