Legislative

SENATE COMMERCE COMMITTEE APPROVES S-114
The Senate Commerce Committee today approved S-114, a measure that would require managed care plans to pay healthcare claims based on assignment of benefits.

MSNJ's Dr. Niranjan Rao and New Jersey Hospital Association’s Valerie Sellers and Randy Minniear were on hand to testify in support of the bill, sponsored by Loretta Weinberg (D-Teaneck). It would require a managed care plan with an out-of-network benefit to reimburse that out-of-network provider directly, rather than to the covered person. Currently, a carrier that offers a managed care plan reimburses the covered person directly for benefits received by an out-of-network provider. The healthcare provider is left to either bill the patient upfront for the service or attempt to recover payment that has been made by the carrier directly to the member.

“The common and accepted practice (which is in the financial interest of patients) is that a non-participating provider obtains the patient’s consent to receive payment from the carrier,” stated Sellers. “However, carriers are not honoring the signed statements from their members. It has become a standard practice on the part of carriers to disregard a member’s authorization to pay the provider directly and instead simply forward a check, for what can be a significant sum, directly to the member.”

The bill now heads to the full Senate.

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PROPOSAL BY DOBI NOT A SOLUTION TO RISING COSTS OF MEDICAL MALPRACTICE INSURANCE
MSNJ has opposed a recent proposal by the Department of Banking and Insurance in the New Jersey Register to permit insurers to offer medical malpractice liability insurance policy forms that include defense costs within policy limits. The proposal allows insurers to offer “wasting” policies…see comments

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NJ CULTURAL COMPETENCY - CME REGULATION
On April 7th the Board of Medical Examiners adopted the new law requiring physicians receive CME credit in Cultural Competency for licensing renewal. MSNJ opposed the mandate because legislators should not prescribe CME to doctors. Nevertheless. the law states physicians, podiatrists, and practitioners who were licensed to practice medicine prior to March 24, 2005 and did not receive instruction in cultural competency training as part of the curriculum of a college of medicine shall, as a condition of the next renewal after March 24, 2008, document completion of CME before being granted licensure renewal and the training shall be in addition to the CME required by the Board. More details

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