NJ Surprise Bill Regulatory Alert — DOBI Publishes Implementation Bulletin

On November 20, 2018, The New Jersey Department of Banking and Insurance (“DOBI”) released Bulletin No. 18-14 (the “Bulletin”) relating to Implementation of P.L. 2018 C. 32 (N.J.S.A. 26:2SS-1 to -20) Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act (the “Surprise Bill Act”).  As a reminder, the Surprise Bill Law relates to ER and involuntary out-of-network care for services rendered on or after August 30, 2018 under fully insured plans, MEWA, the State Health Benefits Program and The School Employees’ Health Benefit Program.  The Bulletin is intended to provide implementation guidance regarding the Surprise Bill Law pending the adoption of rules. DOBI intends to propose such rules in the near future.  Please see the Bulletin in its entirety at the link below:

DOBI Bulletin 11.20.18

The Bulletin includes references to the following attachments:

• Attachment A:   Appeal and Arbitration Process Grid
• Attachment B:   Application for Arbitration of Payment for Inadvertent, Emergency or Urgent Out-of-Network Health Care Services
• Attachment C:   Disclosures to Covered Persons Regarding Out-of-Network Treatment