This bill amends existing health insurance regulations in New Jersey to establish additional network adequacy standards specifically for health insurance carriers that offer managed care plans. It mandates that the Commissioner of Banking and Insurance adopt regulations to ensure that covered individuals have reasonable and timely access to physician specialists at in-network hospitals and facilities. The bill highlights the importance of access to various specialists, including anesthesiologists, radiologists, pathologists, and emergency medicine physicians, thereby enhancing the quality of care available to patients.

In the amendments, the bill replaces references to "this act" with the specific citation of P.L.1997, c.192 (C.26:2S-1 et seq.) and emphasizes the need for regulations that govern consumer protection and quality standards. It also outlines the necessity for a quality management program, provider participation, and a complaint system for covered persons, ensuring that the regulations align with the standards set for health maintenance organizations in the state. The act is set to take effect immediately upon passage.

Statutes affected:
Introduced: 26:2S-18