New Jersey Moves to Make Out-of-Network Charges More Transparent

Legislators in New Jersey have passed legislation aimed at increasing the transparency of health care prices, especially fees for services rendered by out-of-network providers. When it takes effect less than 90 days from now, healthcare facilities and providers will be required to give patients information on network status prior to delivering nonemergent or nonurgent care. That last stipulation is what should be of interest to urgent care operators: The law says care provided on an “emergency or urgent basis” out-of-network cannot cost more than a patient’s deductible, copayment, or coinsurance would be for in-network coverage. All providers, regardless of setting, will be required to give patients an estimate of what their care will cost upon request and to display standard charges. Payers will have to give their plan members written notice of network changes and provide detailed information on out-of-network services.