Assembly Committee Advances Schaer Bill Requiring Health Care Providers to Notify Patients of Out-of-Network Referral

Legislation Heads to Assembly Speaker for Further Review 

(TRENTON) – In an effort to prevent surprise medical bills for consumers, Assemblyman Gary Schaer sponsors a bill that would require health care providers to notify patients of out-of-network referrals.

Under the bill (A-3817), physicians and other health care professionals would be required to provide written notice to their patients whenever referring them to another provider who is outside the health insurer’s network. The notice would have to explain the patient’s financial responsibility for out-of-network services compared to in-network services, and include a list of any in-network providers within the same general area as the out-of-network provider to whom they are being referred.

The bill would not apply to health care professionals providing services to patients who have a point-of-service insurance plan, since those patients do not require referrals or prior authorization.

Upon the legislation being advanced by the Assembly Financial Institutions and Insurance Committee, Assemblyman Schaer (D-Bergen, Passaic) issued the following statement:

“Medical bills from in-network providers are already expensive enough as it is for most patients. Having to pay even more for out-of-network services can put undue financial strain on people who could just as easily receive the same care from an in-network provider. Physicians and other health care professionals have a responsibility to act in the best interest of their patients, which should include the monetary impact of their medical advice and treatments. By requiring providers to notify patients in advance whenever a referral is for an out-of-network doctor, patients will have the ability to make an informed decision before seeking care.”