NJ S504

Requires all New Jersey health insurance carriers, including the State Health Benefits Program and School Employees' Health Benefits Program, to accept into their provider networks any state-licensed health care facility or provider entity in good standing upon application.

Mandates carriers reimburse network providers at no less than 200% of the Medicare reimbursement rate for equivalent services, unless the provider agrees to a different rate.

Establishes a 90-day deadline for carriers to respond to network applications and complete credentialing, with automatic provisional network inclusion if the deadline is missed.

Prohibits carriers from excluding providers based on ownership structure, size, or hospital system affiliation, ensuring patients can receive in-network benefits at any willing state-licensed facility.

Appropriates $2 million to the Department of Banking and Insurance for enforcement, with violations subject to civil penalties up to $25,000 per occurrence and potential license suspension or revocation.