Out-of-Network Consumer Protection, Transparency, Cost Containment, and Accountability Act
On June 1, 2018, New Jersey Governor Phil Murphy signed the “Out of Network Consumer Protection, Transparency, Cost Containment and Accountability Act,” A2039 into law (“The Act”). The Act has been designed to protect healthcare consumers from unexpected billing for out-of-network (OON) charges, as well as promote transparency for physician and facility fees incurred by patients.
This longdebated legislation adds several important administrative responsibilities to
individual healthcare providers, facilities and insurance carriers in the State of New
Jersey. If provisions of the ACT are violated, it will affect your payments, and can
also result in fines and disciplinary actions.
What you will learn:
- Overview of the Law as it pertains to physician practices
- Provider disclosure requirements for in-network and out-of-network patients
- How the law affects your practice’s ability to waive co-pays and deductibles
- How the definition of emergent, urgent and inadvertent care affect your practice’s reimbursement
- Fines for non-compliance
- Practical tools and strategies to comply with the law
- Sheila Mints, Esq. – Capehard Schart
- Susan Lieberman, MBA – Conventus