Physician Survey Shows Strong Opposition to the Proposed “Out-of-Network” Bill

The newly-formed New Jersey Doctor-Patient Alliance, a non-profit social-action committee representing physicians and patients, released a survey that showed how A-1952/S-1285, the proposed “Out-of-Network” bill, would greatly limit patient access to care.

Many doctors would close shop or leave the state, according to the survey results. Of the 117 doctors who completed the survey, 50 percent said they would consider practicing medicine in another state, while 20 percent would leave medicine altogether.

The “Out-of-Network” bill has been proposed to control medical costs and to ensure that patients do not receive surprise bills. All the respondents agree that these are worthwhile and achievable goals. However, the bill would also impose unrealistic and unsustainable arbitration limits on how hospitals and medical providers get reimbursed for emergency out-of-network care. With these limits, many providers of emergency care would no longer be able to afford covering the State’s 72 emergency rooms.

“There are many negative consequences to this bill that the public is largely unaware of,” says Dr. Peter DeNoble, president and founding member of the New Jersey Doctor-Patient Alliance, and an assistant clinical professor at Seton Hall University’s Department of Orthopaedic Surgery. “As with so many well-intentioned initiatives by politicians, this one will end up harming the very individuals they seek to protect.”

“The cost of providing medical care in New Jersey has increased by 20 percent since 2001. Meanwhile, reimbursements have remained flat or decreased. It has become difficult for many hospitals and practices to remain solvent. Now, with the potential passage of this out-of-network bill, I’m worried that patients will lose their ability to access the best choice of medical or surgical specialists in New Jersey.”

According to the poll, released today, 78 percent of respondents said it would be an “existential threat” to their practices if out-of-network reimbursements were allowed to follow in-network or Medicare rates. If in-network rates were reasonable, to begin with, these respondents would have gladly joined the networks already. But insurance companies refuse to pay fair in-network rates to specialists. That is why they can’t attract these specialists into their networks, creating an out-of-network problem.

Of the 117 physicians who responded to the survey, 93 percent said they provide at least some services out-of-network. 8o percent provide services through the Emergency Departments of New Jersey hospitals. According to the poll, if the “out-of-network” legislation was to become law, 56 percent said they would take less on-call shifts at Emergency Departments, while 30 percent would drop all or some of their hospital privileges. This would greatly limit the number of doctors serving insured, uninsured, and low-income patients, many of whom use the Emergency Department for primary care.

The NJDPA supports S-3299 introduced recently by Sen. Paul Sarlo and A-4228 introduced by Assemblymen Raj Mukherji, Joseph Lagana, and Jon Bramnick. The bi-partisan legislation requires doctors and hospitals to disclose their fees before services are provided and require insurance carriers to disclose the amount they will cover for these same services.

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