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New Jersey Bans Medical Providers From Charging Claimants for Work-Related Medical Expenses

November 23, 2012 (2 min read)

New Jersey, like many states, has had an ongoing problem with physicians and hospitals that balance bill injured workers for work-related care. This problem has become more acute in the age of managed care reductions where medical providers dispute the amount they are paid and then send invoices to injured workers for the unpaid balance. In response to this widespread problem, Governor Christopher Christie signed into law Assembly No. 2652 on November 19, 2012. It is now known as P.L.2012, c.67.

The law reads as follows:

Fees for treatments or medical services that have been authorized by the employer or its carrier or its third party administrator or determined by the Division of Workers’ Compensation to be the responsibility of the employer, its carrier or third party administrator, or have been paid by the employer, its carrier or third party administrator pursuant to the workers’ compensation law, R.S. 34:15-1 et seq., shall not be charged against or collectible from the injured worker.

In addition, the law vests within the Division of Workers’ Compensation exclusive jurisdiction of any disputed medical charge arising from any claim for compensation for a work-related injury or illness. This means that providers and hospitals who dispute charges arising from workers’ compensation care cannot sue civilly or use other means to collect on such charges. The matter must be decided within the Division of Workers’ Compensation, which has well-established procedures for such medical reimbursement claims. In fact, there are several thousand medical reimbursement claims currently being handled by the New Jersey Division of Workers’ Compensation.

The law goes on to state that “the treatment of an injured worker or the payment of workers’ compensation to an injured worker or dependent of an injured or deceased worker shall not be delayed because of a claim by a medical provider.”

This law makes good sense for all stakeholders in workers’ compensation. The past practice of balance billing injured workers for authorized care caused tremendous anxiety for workers and their families. For employers the law will eliminate a very inefficient system of permitting medical providers to sue in civil court for medical charges arising from workers’ compensation. That practice alone led to procedural nightmares for employers and carriers as well as excessive legal costs.

© Copyright 2012 John Geaney. This article originally appeared on New Jersey Workers’ Comp Blog and is reprinted here with permission.