MSNJ Weighs-in on Insurer Transparency & Accountability

    By: Melinda Martinson, Esq. on Aug 03, 2017

    MSNJ has long advocated for more meaningful explanation of benefits (EOBs) and description of appeal rights for patients. We believe that EOBs on out-of-network bills are purposefully misleading. We have also advocated that insurers be required to pay the fees they agree upon with out-of-network providers under "in-plan exceptions," instead of reverting to their fee schedules. The Department of Banking & Insurance responded with three rule amendments issued under Governor Christie's Executive Order 2 which requires that stakeholders and interested parties be given early notice and opportunity to provide in-put on rule proposals that will affect them. Read our comments suggesting improvements to EOBs, requiring payment for negotiated fees for in-plan exceptions, and requiring compliance with Independent Utilization Review Organization (IURO) determinations. We will keep member apprised of developments with the proposals.

    Released: August 3, 2017, 7:47 am
    Keywords: Announcements

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