Sponsored by:
Senator RICHARD J. CODEY
District 27 (Essex and Morris)
Senator JOSEPH F. VITALE
District 19 (Middlesex)
SYNOPSIS
Establishes cap on amount that hospital can charge patients for laboratory services to 150% of Medicare.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning hospital charges for laboratory services and supplementing Title 26 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Except as provided by section 1 of P.L.2008, c.60 (C.26:2H-12.52), a hospital that is licensed by the Department of Health pursuant to P.L.1971, c.136 (C.26:2H-1 et al.) shall charge a patient in this State an amount no greater than 150% of the applicable payment rate under the federal Medicare program, established pursuant to Pub.L.89-97 (42 U.S.C. s.1395 et seq.), for any laboratory services that are rendered to the patient.
2. This act shall take effect immediately.
STATEMENT
This bill would prohibit a hospital from billing certain patients for laboratory services in an amount that exceeds 150% of the applicable payment rate under the federal Medicare program.
Under existing law, at P.L.2008, c.60 (C.26:2H-12.52 et seq.), whenever a hospital provides health care services (including laboratory services) to an uninsured patient whose family gross income is less than 500% of the federal poverty level, the hospital is prohibited from charging the patient more than 115% of the applicable payment rate for those services under the federal Medicare program. This bill would establish a similar cap on charges for laboratory services that are provided to patients who do not satisfy the income and other requirements of P.L.2008, c.60. In particular, the bill would provide that, except in cases where the provisions of P.L.2008, c.60 are applicable, a hospital will be prohibited from charging a patient in this State more than 150% of the applicable payment rate under the federal Medicare program for any laboratory services that are rendered to the patient. The existing 115% cap established under P.L.2008, c.60 would still be applicable to laboratory and other health care services that are provided by a hospital to uninsured persons who satisfy the applicable income requirements.