On behalf of the New Jersey Society of Plastic Surgeons (NJSPS) and the American Society of Plastic Surgeons (ASPS), we request that you support S-3299 regarding out-of-network patient notification requirements. The New Jersey Society of Plastic Surgeons is the largest association of plastic surgeons in New Jersey, and in conjunction with our national affiliate the American Society of Plastic Surgeons, collectively represent 220 board-certified plastic surgeons in the state.
On behalf of the New Jersey Society of Plastic Surgeons (NJSPS) and the American Society of Plastic Surgeons (ASPS), we request that you support S-3299 regarding out-of-network patient notification requirements. The New Jersey Society of Plastic Surgeons is the largest association of plastic surgeons in New Jersey, and in conjunction with our national affiliate the American Society of Plastic Surgeons, collectively represent 220 board-certified plastic surgeons in the state.
Following the passage of the Affordable Care Act, insurers have created products with narrow, inadequate, and non-transparent physician networks. These “narrow networks” often force patients “out-of-network” for needed care. When patients receive care from a provider they did not know was outside their network, they are surprised after the fact that their insurance will not cover the services provided. We appreciate your effort to address this issue through better informing patients about their coverage.
NJSPS and ASPS commend the legislature for pursuing robust patient notification provisions. We believe insurers, facilities, and providers all share responsibility for communicating network-related information to patients, so we were pleased the see the proposed patient disclosure requirements included in S-3299. Much of the surprise billing problem can be addressed by fully informing patients, and allowing them to decide whether they agree to receive care from out-of-network providers. Additionally, S-3299 closes an essential loophole in transparency and disclosure by legally mandating employers that provide self-funded plans to educate their employees about the coverage available.
NJSPS and ASPS also believe that in addition to disclosure requirements, insurers should be held accountable for decisions made based on contents in their directories. If a patient makes a careful decision based on this directory, the insurer should be held financially responsible for treating the situation as if their directory is accurate.
Debra Johnson, MD President,
American Society of Plastic Surgeons
Negin Noorchashm Griffith, MD, FACS
President, New Jersey Society of Plastic Surgeons