New Jersey § 30:4d-6g

§ 30:4d-6g.

The Legislature finds and declares that: a. In accordance with the “Health Care Reform Act,” P.L.1992, c. 160 ( C.26:2H-18.51 et al.), it has been and continues to be of paramount public interest for the State

to take all necessary and appropriate actions to ensure access to, and the provision

of, cost-effective and high-quality hospital care to its citizens. Consistent with these goals, it is and has been the policy of this State that reimbursement

for emergency services and related screening and hospitalization be reasonable, in

order to promote access to such care without overburdening the health care payment

system. These imperative public policies continue to apply equally to both public and private

payers of health care services; b. In light of the provisions of section 14 of the “Health Care Reform Act,” P.L.1992, c. 160 ( C.26:2H-18.64 ), which prohibits hospitals from denying admission or appropriate services to a patient

on the basis of that patient's ability to pay or source of payment, questions have

arisen as to the rates at which emergency services should be reimbursed when they

are provided to enrollees in Medicaid and NJ FamilyCare managed care plans by non-participating

hospitals. In order to ensure that the goal of cost-efficient access to emergency services

is furthered, it is necessary to clarify the rates that have been and continue to

be deemed reasonable reimbursement; and c. It is necessary that the reimbursement clarification be understood as reaffirming

the paramount public health and welfare purpose of promoting cost-efficiency in the

delivery of emergency services and related screening and hospitalization.