NJ A5810

Eliminates fees for covered persons and health care providers to appeal health insurance carrier decisions that deny, reduce, or terminate benefits through the Independent Health Care Appeals Program

Allows covered persons to sign a consent form prior to receiving hospital services authorizing a health care provider to appeal carrier determinations on their behalf through all stages of the appeals process

Requires health care providers to notify covered persons whenever they initiate or continue an appeal of a carrier's benefit denial, reduction, or termination

Appeals must be filed within 60 days of the carrier's final decision and require submission of carrier information, description of the medical condition, and written consent to obtain medical records

Amends P.L.1997, c.192 (C.26:2S-11); effective immediately upon approval on June 30, 2025