NJ S1025

Creates a 7-member Commission on Insurance Reimbursement within the Department of Banking and Insurance, including the Commissioner (or designee), representatives from the State Board of Medical Examiners, Medical Society of New Jersey, New Jersey Hospital Association, New Jersey Association of Health Plans, and two public members representing patient advocacy organizations.

Requires health insurance carriers to submit applications for approval before reducing payment rates for any Current Procedural Terminology (CPT) code when appended with modifiers.

Commission must evaluate whether proposed reductions would interfere with patient access to care, adversely affect the stability of the state's health care system, or negatively impact licensed health care providers and facilities.

Final written determinations on applications must be issued within 60 days, with applicants given the opportunity to be heard before the commission; the commission may approve, partially approve, or deny applications.

Commission must submit annual reports to the Governor and Legislature summarizing determinations, findings, activities, and recommendations for changes to health benefits plan laws.