New Jersey bill would prohibit co-pay waivers

NEWS IN BRIEF — Posted April 5, 2010

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New Jersey physicians are mounting opposition to a bill that would outlaw doctors' ability to waive patients' out-of-network co-payments, making the practice a form of insurance fraud. Physicians found in violation of the measure would be subject to criminal and civil penalties.

The bill, introduced in the state Senate in March, was prompted in part by a 2009 state appeals court decision rejecting a health plan's arguments that an out-of-network surgery center engaged in fraud when it waived patients' coinsurance payments. The insurance industry argued that such practices drive up health care costs because they lead to overpayment for doctors' services.

Physicians say the bill, if passed, would intrude on the physician-patient relationship and doctors' rights to negotiate out-of-pocket costs based on patients' ability to pay. The Medical Society of New Jersey has not taken a formal position on the legislation but is expected to oppose it.

Note: This item originally appeared at

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