The bill mandates that health insurance carriers in New Jersey must allow clinical laboratories and laboratory services providers to participate as preferred or contracting providers within their networks. It amends existing laws to ensure that contracts for pharmacy services, prescription drugs, and laboratory services permit subscribers to select their preferred providers without discrimination based on corporate structure, size, or location, provided the providers meet credentialing standards. The bill also requires health service corporations to provide written notice of participation requirements and respond to applications for participation within 60 days. Additionally, it prohibits the imposition of additional fees or conditions on subscribers selecting these providers that are not equally applied to all subscribers.

Furthermore, the bill establishes that health service corporations and insurers must allow enrollees to select their pharmacy, pharmacist, clinical laboratory, or laboratory services provider without discrimination, as long as the providers meet the necessary standards. It mandates that any denial of participation must include specific criteria that were not met and a process for reconsideration. The bill also ensures that pharmacies must disclose any additional service charges before dispensing drugs and prohibits them from charging for patient counseling or other mandated services. Overall, the legislation aims to enhance access to laboratory and pharmacy services while promoting fairness and transparency within health insurance networks.

Statutes affected:
Introduced: 17:48-6, 17:48A-7, 17:48E-35.7, 17B:26-2.1, 17B:27-46.1, 26:2J-4.7