New Jersey § 52:17b-199
Full text of New Jersey New Jersey Statutes § 52:17b-199, with citation guidance and answers to common questions.
§ 52:17b-199.
of Banking and Insurance and Health and Senior Services, that the carrier has substantial
market power in its service area and that any of the terms or conditions of the contract
with the carrier pose an actual or potential threat to the quality and availability
of patient care among covered persons, two or more independent physicians or dentists
who are practicing in the service area of a carrier may jointly negotiate with the
carrier and engage in related joint activity, as provided in this act regarding fees
and fee-related matters, including, but not limited to, any of the following: (1) the amount of payment or the methodology for determining the payment for a health
care or dental service, including, but not limited to, cost of living increases; (2) the conversion factor for a resource-based relative value scale or similar reimbursement
methodology for health care or dental services; (3) the amount of any discount on the price of a health care or dental service; (4) the procedure code or other description of a health care or dental service covered
by a payment and the appropriate grouping of the procedure codes; (5) the amount of a bonus related to the provision of health care or dental services
or a withholding from the payment due for a health care or dental service; and (6) the amount of any other component of the reimbursement methodology for a health
care or dental service. b. The Department of Banking and Insurance, in consultation with the Department of
Health and Senior Services, shall have the authority to collect and investigate such
information as it reasonably believes is necessary to determine, on an annual basis: (1) the average number of covered lives and geographical distribution of covered lives
per quarter per county for every carrier in the State; and (2) the impact of the provisions of this section on average physician or dentist fees
in the State. The Department of Banking and Insurance shall provide this information to the Attorney
General on an annual basis.
Frequently Asked Questions About New Jersey § 52:17b-199
What does New Jersey Statutes § 52:17b-199 cover?
Section 52:17b-199 is part of the New Jersey Statutes, the codified statutory law of New Jersey. It sets out the legal rule or procedure described in the text above. Statutes are amended regularly, so always verify against the official source.
How do I cite New Jersey § 52:17b-199?
A common citation format is "New Jersey Statutes § 52:17b-199" (New Jersey). Legal writing may require the code abbreviation, section number, and year or edition. Match the style required by your court, professor, or publisher.
Is this the official text of New Jersey law?
No. This page is for research and education and may not include the most recent amendments. For official current law, check the New Jersey official source linked on this page or consult a licensed New Jersey attorney.
How does New Jersey § 52:17b-199 apply to my situation?
Statutes are interpreted in context, and application depends on your specific facts. Only a licensed attorney in New Jersey can advise on how this section applies to you. Contact your state or local bar association for a referral.
Sources & Verification
Not legal advice. Verify against the official source and consult a licensed attorney in New Jersey.