This bill mandates that health insurance carriers and Medicaid reimburse clinical laboratories for laboratory services, irrespective of the laboratories' participation in managed care plans. Specifically, it requires that carriers offering managed care plans must pay licensed clinical laboratories at the same rate as they would for participating laboratories for comparable services. Additionally, managed care organizations under the Medicaid program are also required to adhere to this reimbursement policy. Both carriers and managed care organizations retain the right to review the services provided for medical necessity.

Furthermore, the bill prohibits the Division of Medical Assistance and Health Services in the Department of Human Services from requiring licensed clinical laboratories to participate in the managed care delivery system or transition from a fee-for-service model to a managed care model in order to receive Medicaid reimbursement. This legislation aims to ensure equitable access to laboratory services for all clinical laboratories, thereby enhancing the overall healthcare delivery system in New Jersey. The act is set to take effect 180 days after enactment and will apply to health benefits plans and contracts entered into or renewed after that date.