N.J. just took a big step to spare you from those costly surprise out-of-network medical bills

Updated Jun 1; Posted Jun 1
By Matt Arco

More than 170,000 New Jerseyans receive surprise medical bills each year that add up to hundreds of millions of dollars, Gov. Phil Murphy said Friday.

And with that in mind, the governor signed legislation that he and others say will help to curb the problem and better inform patients in the state about what they can expect to pay for medical care.

“We are all here today to declare an end to the days of surprise medical bills,” Murphy said during an event in Woodbridge.

“We are opening a new era of transparency,” he said. “This is a huge win.”

With the firm backing of state Assembly Speaker Craig Coughlin, D-Middlesex, Murphy signed the “Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act.”

“There’s probably no family that I know that hasn’t been directly or indirectly affected (by surprise bills),” Coughlin said. “It is a big deal. It’s a big deal for the people of New Jersey.”

The new law will protect thousands of New Jerseyans covered by state-regulated health plans from “balance-billing,” or paying what an insurance company won’t.

It lets both medical providers and insurers who can’t settle a billing dispute on their own submit evidence and accept the decision of an independent arbiter, who must choose between the two offers.

“Surprise medical billing was a problem that for far too long had gone unresolved in New Jersey,” Better Choices, Better Care NJ, a health care advocacy group said in a statement. “After much work and discussion, we now have a solution that will save consumers countless dollars.

According to a recent poll, one in seven people in New Jersey in the last year received an expensive medical bill they had not expected from doctors, hospitals and other providers both inside and outside their insurance network.

The problem has gotten worse over time, according to a report on the poll. Insurance companies have created plans with narrow networks of providers with whom they’ve negotiated discounts. Deductibles, co-pays and out-of-pocket expenses are higher. And more doctors, depending on the specialty, refuse to take some or most insurance coverage.

New Jersey Policy Perspective, a left-leaning advocacy group, estimates surprise billing is a $1 billion problem in the Garden State.

NJ Advance Media staff writer Susan K. Livio contributed to this report.