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. The amendments require the Commissioner of Banking and Insurance to adopt regulations that ensure covered individuals have reasonable and timely access to various physician specialists, including anesthesiologists, radiologists, pathologists, and emergency medicine physicians, at in-network hospitals and facilities.

The bill also updates the legal language to clarify that the regulations must align with the standards governing health maintenance organizations in the state. It emphasizes the importance of a quality management program, provider participation, and a comprehensive complaint and appeals system for covered persons. The act is set to take effect immediately upon passage.

Statutes affected:
Introduced: 26:2S-18