This bill establishes a regulatory framework for barring certain health care providers from receiving reimbursement under personal injury protection (PIP) coverage from automobile insurers. The Commissioner of Banking and Insurance, in collaboration with the Commissioner of Health and Senior Services and the Director of the Division of Consumer Affairs, is tasked with creating standards and procedures for investigating health care providers suspected of professional misconduct, incompetence, or other violations. The bill mandates that health care providers receive adequate due process, including notice and an opportunity to be heard, and requires that they be informed of any new regulations at least 90 days prior to their implementation.
Additionally, the bill outlines specific grounds for investigation, such as billing for services not rendered or soliciting patients improperly. If a health care provider is found to have violated these standards, the Commissioner may bar them from receiving reimbursements and compile a public list of such providers. The bill also prohibits barred providers from treating patients for remuneration under PIP coverage and allows injured claimants to use this as a defense in payment disputes. Furthermore, the Commissioner has the authority to temporarily suspend a provider's reimbursement rights during an investigation, ensuring that the process is transparent and accessible to the public through online resources and a toll-free number.