Out-of-network bills headed to Senate committee despite concerns from hospital group
“We totally agree with the sponsors that something needs to be done to protect consumers,” said NJHA spokeswoman Kerry McKean Kelly. “But we can’t support the bill in its current draft.”
The problem is the arbitration process, which was added to the bill to replace capped costs for out-of-network services — part of the original draft of the bill.
If the insurance company and health facility cannot agree on a reimbursement rate for the services provided within 45 days of the date billed for service, all parties can enter into binding arbitration, according to the newest draft.
“We think (arbitration) would tilt the negotiating process in favor of the (insurers) and will put hospitals at a disadvantage when sitting across from insurance companies to negotiate in-network rates,” Kelly said.
But NJHA didn’t support the capped system either.
“No one reached a point where they were in agreement on the capped system, as well,” Kelly said.
So will this create yet another snag for legislation closely watched by both consumers and employers who need a stop to bills for $8,775 bandages and $17,000 stitches?
“It’s tough to tell. There are so many complexities here,” Kelly said, adding that the bill may not pass during the current lame duck session.
Assemblyman Troy Singleton (D-Mount Laurel), a sponsor of the legislation, disagreed.
“I’m not sure what snags people are talking about. It’s going to be heard at the Senate Commerce committee on Thursday. The process is moving along,” he said.