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 a 90-day advance notice before the implementation of any new regulations.
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 reimbursement and compile a public list of such providers. Additionally, those barred from reimbursement are prohibited from treating patients for payment under PIP coverage, and any claims for payment by these providers can be contested by injured claimants. The bill also allows for temporary suspensions of providers during investigations, ensuring that the process is transparent and accessible to the public through online resources and a toll-free number.