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Committee Panel Advances Sumter & Benson Bill to Relieve Strain of Health Insurance Claim Deadlines

Measure to Extend Filing Period to Within 365 Days of Care

To provide more time for a healthcare claim to be filed, the Assembly Financial Institutions and Insurance Committee advanced legislation on Thursday sponsored by Assembly Democrats Shavonda Sumter and Daniel Benson.

The bill (A-4261) would permit claims filed by health care professionals, health care facilities, and insured individuals – for treatment provided between January 1, 2020 and the end of the declared public health and state emergencies – to be submitted within 365 days of the date of service.

The measure’s sponsors issued the following statements:

Assemblywoman Shavonda Sumter (D-Bergen, Passaic): “Many doctor’s offices, especially the smaller practices, are under financial strain and have had to reduce their staff to cope during this pandemic. This has left many struggling to manage and keep up with the 90-day deadline to submit claims, or 180-days for Medicaid, currently required by law. The extended period created by this legislation would provide more time so that access to fair, affordable health coverage is protected.”

Assemblyman Daniel Benson (D-Mercer, Middlesex): “Individuals seeking out healthcare shouldn’t have to face surprise costs or incur medical debt because an otherwise valid claim could not be submitted on time. COVID-19 has put a strain on our healthcare system in unexpected ways. Some administrative leeway is what’s critical right now, so doctors can focus on providing care and so a patient’s right to coverage is safeguarded.”

The bill now goes to the Speaker for further consideration.