Out-of-Network Bill Deserves Floor Votes This Week, NJBIA Says

Legislation released by the Senate Budget and Appropriations Committee on June 26 is an effective way to rein in the cost of “surprise” out-of-network medical bills and should be voted on Thursday, the New Jersey Business & Industry Association said today.

“This is a good bill that deserves to be passed before the Legislature finishes its work for the summer,” said NJBIA President and CEO Michele Siekerka. “It is a balanced and effective way to address an extremely difficult problem. The sponsors in both the Senate and Assembly have worked tirelessly over the last two years to get us to this point, and we should not let this opportunity go by. Let’s finish the job.”

NJBIA supports S-1285 (Vitale, D-19; Weinberg, D-37) as well as a companion bill, A-1952 (Coughlin, D-19; Schaer, D-36), which was released by the Assembly Budget Committee last fall and is awaiting action in the full Assembly.

Both bills would set limits on payment to out-of-network healthcare providers in emergency or inadvertent situations, establish an arbitration process, and require more transparency on the in-network status of healthcare providers.
Mary Beaumont, NJBIA vice president of Health and Legal Affairs, said out-of-network reform was essential to reining in the high cost of health insurance that businesses face.

“Business owners want to provide health benefits as a way to attract and keep good employees, to the point that they will sacrifice their own profits so they can continue to offer coverage,” Beaumont said. “Out-of-network costs play an increasingly significant role in the rising cost of healthcare for both large and small employers in New Jersey, triggering both higher premiums and out-of-pocket expenses.”

According to NJBIA’s 2016 Health Benefits Survey, the insurance that businesses provided their employees costs an average of $7,044 for employee-only coverage and $17,580 for family coverage. To cover the costs, 33 percent of companies lowered profits, 29 percent limited raises for employees and 15 percent delayed investments to find the money needed to provide this benefit, the survey showed.