Sponsored by:
Assemblywoman DONNA M. SIMON
District 16 (Hunterdon, Mercer, Middlesex and Somerset)
SYNOPSIS
Requires medical bills be standardized and accompanied by explanatory disclosure form.
CURRENT VERSION OF TEXT
As introduced.
An Act requiring standardized and itemized medical billing, amending P.L.2009, c.263, and supplementing Titles 26 and 45 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 1 of P.L.2009, c.263 (C.26:2H-5.1c) is amended to read as follows:
1. An ambulatory care facility licensed to provide surgical services pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) shall use a common billing form, designated by the Commissioner of Health and Senior Services, for each patient when billing for health care services. The information provided on the billing form shall, to the extent applicable, be the same as that required of hospitals.
A claim, bill, demand for payment, or other billing form presented, or caused to be presented, by an ambulatory care facility to a patient who received health care services provided by the facility, or to an immediate family member of the patient or other person legally responsible for the debts or care of the patient, shall be accompanied by a disclosure form, designated by the Commissioner of Health and Senior Services, which explains each item on the claim, bill, demand for payment, or other billing form, clearly denoting the cost to the patient and the purpose of each service performed. The information provided on the disclosure form shall, to the extent applicable, be the same as that required of hospitals.
(cf: P.L.2009, c.263, s.1)
2. (New section) A health care facility as defined in section 2 of P.L.1971, c.136 (C.26:2H-2) shall use a common billing form, designated by the Commissioner of Health and Senior Services, for each patient when billing for health care services.
A claim, bill, demand for payment, or other billing form presented, or caused to be presented, by a health care facility to a patient who received health care services provided by the facility, or to an immediate family member of the patient or other person legally responsible for the debts or care of the patient, shall be accompanied by a disclosure form, designated by the Commissioner of Health and Senior Services, which explains each item on the claim, bill, demand for payment, or other billing form, clearly denoting the cost to the patient and the purpose of each service performed.
3. (New section) A physician licensed pursuant to Title 45 of the Revised Statutes shall use a common billing form, designated by the State Board of Medical Examiners in coordination with the Commissioner of Health and Senior Services, for each patient when billing for health care services. The information provided on the billing form shall, to the extent applicable, be the same as that required of hospitals.
A claim, bill, demand for payment, or other billing form presented, or caused to be presented, by a physician to a patient who received health care services provided by the physician, or to an immediate family member of the patient or other person legally responsible for the debts or care of the patient, shall be accompanied by a disclosure form, designated by the State Board of Medical Examiners, which explains each item on the claim, bill, or demand for payment, clearly denoting the cost to the patient and the purpose of each service performed.
4. Pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), the State Board of Medical Examiners and the Commissioner of Human Services may adopt rules and regulations necessary to effectuate the purposes of this act.
5. This act shall take effect on the first day of the seventh month next following the date of enactment, but the Commissioner of Health and Senior Services and the State Board of Medical Examiners may take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of this act.
STATEMENT
This bill requires that medical bills delivered to a patient or the patient's surrogate be standardized and itemized, clearly denoting the cost and purpose of each item on the bill.
Any claim, bill, demand for payment, or other billing form presented to the patient who received health care services from a health care facility, ambulatory care facility, or physician, or to an immediate family member of the patient or other person legally responsible for the debts or care of the patient, is to be accompanied by a disclosure form which explains each item on the claim, bill, or demand for payment, clearly denoting the cost to the patient and the purpose of each service performed.
The bill requires that the Commissioner of Health and Senior Services designate a standard billing form and a standard accompanying disclosure form explaining any charges on the associated bill, which to be used by health care facilities. The commissioner is also to designate such forms to be used by ambulatory care facilities, which are to contain the same information as those forms required of hospitals, as applicable.
The bill requires the State Board of Medical Examiners, in coordination with the Commissioner of Health and Senior Services, to designate a standard billing form and a standard accompanying disclosure form explaining any charges on the associated bill, which is to be used by physicians.