Measure Aims to Educate Consumers on Hospital Transfers Prior to the Process, Protect From Surprise Billing
Recognizing the anxiety and unexpected financial liabilities that can occur when a patient is transferred to an out-of-state health care facility, a measure sponsored by Assembly Deputy Parliamentarian Nicholas Chiaravalloti to help educate patients about such transfers and available options before they take place was approved 57-12-3 Thursday by the full Assembly.
- The patient’s right to receive care at a facility of choice;
- Clinical rationale for the out-of-state transfer;
- Location of the out-of-state facility;
- Availability of clinically appropriate services at nearby New Jersey facilities;
- The nature of the relationship if the patient is being transferred or referred to an affiliated facility; and
- In instances of trauma, an explanation as to why the patient is not being transferred to a Level 1 or Level 2 Trauma center in New Jersey.
The measure would also require licensed health care professionals to notify a patient’s health insurance carrier or self-funded health benefits plan sponsor prior to transferring the patient to an out-of-state health care facility.
“A well-informed patient is in a better position to make better decisions and be better protected from unexpected costs and inconveniences—especially as it pertains to hospital transfers,” said Chiaravalloti. “But a patient can’t make a sound medical decision when they don’t have this information before the transfer takes place.”
The Act also stipulates that facilities establish and maintain communication between the patient and the health insurance carrier or self-funded health benefits plan sponsor to inform the patient about the network status of the out-of-state facility or provider, and any out-of-pocket costs for which the patient would be responsible.
“This type of communication is necessary to help the patient understand whether specific services are covered under their health benefits plan and the estimated out-of-pocket costs to be incurred because of the out-of-state transfer,” said Chiaravalloti.
The bill cleared the Assembly Health and Senior Services Committee on May 20. A companion bill in the Senate (S-3816) is under review.