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NJ S1022
Bill
Status
1/13/2026
Primary Sponsor
Jon Bramnick
Click for details
AI Summary
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Prohibits health insurance payers from using "downcoding" to reduce reimbursements below what provider contracts require for services actually performed
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Defines downcoding as adjusting claims to less complex or lower cost service codes to pay providers less than contractually owed, including through remark codes
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Applies to insurance companies, health service corporations, health maintenance organizations, organized delivery systems, and their agents operating in New Jersey
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Requires the Department of Banking and Insurance to adopt implementing regulations
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Takes effect 180 days after enactment
Legislative Description
Prohibits downcoding in health insurance claims.
Commerce
Last Action
Introduced in the Senate, Referred to Senate Commerce Committee
1/13/2026