A contentious bill returned to the New Jersey state Assembly yesterday, in an effort to ensure managed care networks have enough physicians for patients to choose from, according to NJ Spotlight.
The bill, A-1922/S-1211, passed the full Assembly in 2011, but was voted down in the Senate, according to the report. If passed, it would require payers to hire firms to conduct audits of provider networks. The state auditor would also conduct a separate review of payers that operate managed care organizations for Medicaid beneficiaries, according to the report.
Proponents of the bill believe it will help expand managed care networks and keep patients from flooding emergency rooms due to insufficient available providers.
However, opponents believe the increased state oversight is unnecessary.
The New Jersey Departments of Banking and Human Services are already responsible for managed-care networks and the proposed legislation will result in four redundant audits, Wardell Sanders, president of the New Jersey Association of Health Plans, told NJ Spotlight. Mr. Sanders said participation in managed care networks is low because reimbursement rates for Medicaid are so low. The state has some of the lowest Medicaid reimbursement rates in the nation, according to the report.
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