ASSEMBLY, No. 113

STATE OF NEW JERSEY

Introduced Pending Technical Review by Legislative Counsel

PRE-FILED FOR INTRODUCTION IN THE 1996 SESSION

By Assemblyman JONES and Assemblywoman GILL

An Act concerning the regulation of physicians and supplementing Title 45 of the Revised Statutes.

    Be It Enacted by the Senate and General Assembly of the State of New Jersey:

    1. a. A physician licensed pursuant to the provisions of Title 45 of the Revised Statutes who provides medical services to a beneficiary of health insurance under Title XVIII of the federal Social Security Act, Pub.L.89-97 (42 U.S.C. § 1395 et seq.) shall not charge or collect from the beneficiary any amount in excess of the reasonable charge for that service as determined by the United States Secretary of Health and Human Services.

    b. The State Board of Medical Examiners shall assess a civil penalty pursuant to sections 9 and 11 of P.L.1978, c.73 (C.45:1-22 and 45:1-25) of $2,500 for a first offense and $5,000 for each subsequent offense against any physician who is not in compliance with this act.

    2. a. All penalties collected pursuant to P.L. ,c. (C. )(now pending before the Legislature as this bill) shall be deposited in a special non-lapsing fund in the Department of Health which is designated as the "Senior Citizen Health Care Grant Fund." The fund shall be dedicated for use by the Commissioner of Health to award grants to nonprofit organizations for the development of innovative health care programs for senior citizens.

    b. Within one year after the effective date of this act, and annually thereafter, the Commissioner of Health shall report to the Legislature on the amount collected and the use of the fund.

    3. Pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), the Commissioner of Health shall adopt rules and regulations necessary to carry out the purposes of this act.

    4. This act shall take effect immediately.

STATEMENT

    This bill requires physicians who agree to treat Medicare patients to accept what the program pays without billing the patients for the uncovered balance.

    Physicians who do not comply with this requirement shall be subject to a fine of $2,500 for the first offense and $5,000 for each subsequent offense. The monies collected from the fines shall be deposited in a "Senior Citizen Health Care Grant Fund" in the Department of Health. The Commissioner of Health shall use the fund to award grants to nonprofit organizations for the development of innovative health care programs for senior citizens and shall report to the Legislature annually regarding the amount collected and the use of the fund.

Requires physicians who agree to treat Medicare patients to accept what the program pays without balance billing.