Senate Commerce Committee refused to clear S-20 (“Out-of-Network” bill) for consideration by the full NJ Senate
Rajnik Raab, M.D. – NJNS President

When the New Jersey Neurosurgical Society last met in June, 2015, the “Out-of-Network” bill (A-4444/S-20) had just been defeated in the Senate Commerce Committee. It had already failed to clear the Assembly Financial Institutions and Insurance Committee (AFI), and so the Trenton legislative session recessed for the summer without advancement of this onerous new law. Nevertheless, its chief sponsor, Senator Joseph Vitale (D- 19th District), vowed to continue his efforts after the summer recess.

During the summer of 2015, A-4444/S-20 was reworked, and resubmitted during the lame duck session. As before, no physician or hospital stakeholders were invited to contribute. Rather, the new bill represented typical insurance favored cost-containment initiatives, promoting narrow networks, eliminating flexibility, and severely restricting provider reimbursement, all the while ignoring real health care cost drivers in the state.

In a letter sent by our Society to Nia Gil (D – Chair, Commerce Committee), the following was noted:

“S-20 provides a ready example of this pattern: Section 4, dealing with disclosure mandates to facilities, has 651 words. Section 5, dealing with provider disclosure, has 673 words. Finally, Section 6, which details disclosure requirements for insurance companies, has only 357 words. The imbalance is obvious. Moreover, S-20 mandates apply to 100% of the health care providers in our State, but only 30% of the health care insurers. Again, imbalance. The other 70% (self-funded) can operate without transparency, offering expensive insurance products that create the illusion of financial protection to its members, but, in fact, leave them unprotected at the most vulnerable time in their lives – when they become sick.”

Fortunately, on December 10th, the Senate Commerce Committee refused to clear S-20 for consideration by the full Senate. As such, we can cautiously celebrate a small victory in 2015. On this point, I would like to credit members of NJNS, MSNJ, and the Access to Care Coalition for their collaborative efforts to fight S-20. Their diligent “behind the scenes” efforts — phone calls and campaigning to key legislators prior to the Senate Commerce Committee hearing made a major impact on the ultimate outcome. Had bill A-4444/S-20 cleared both committees, and then been sent to the respective floors for full vote, we as providers would have faced our most imminent existential threat since 2007, when Assemblymen Gary Schaer’s OON bill came up for a full Assembly vote and was defeated. As we forge ahead in new legislative session, we can only be successful in protecting the right to practice out of network with your continued involvement and support.