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Insurer skips doctors and sends massive checks to patients, prompting million-dollar lawsuit

(CNN)A woman received nearly $375,000 from her insurance company over several months for treatment she received at a California rehabilitation facility. A man received more than $130,000 after he sent his fiancée's daughter for substance abuse treatment.

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Lagana-Gopal bill would correct some unintended consequences of landmark bill passed this summer

When Gov. Phil Murphy signed the out-of-network law on June 1, some applauded the new administration for ending the nearly decade-long struggle to try to define how insurers pay doctors for services. And while the bill has helped on the issue, it also has caused confusion and acrimony — and created some unintended consequences. Some critics said the law has heavily favored insurance companies and took negotiating power away from doctors who are not “in network” — and that the law was a strategy to force doctors into networks. And both sides have accused each other of attempting to manipulate the process in their favor while awaiting more definitive regulations from the Department of Insurance and Banking.  

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Star-Ledger: What New Jersey can do to address doctor shortage

Read this op-ed as it originally appeared on nj.com. The Star-Ledger recently reported that lawmakers in Washington are looking to close a decades old loophole that is leading to a doctor shortage in New Jersey.  While New Jersey's Congressional delegation should be praised for their efforts to overturn the cap on Medicare-funded slots for doctors in training, it is only one of the reasons why New Jersey residents are losing access to medical doctors and surgeons.

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NJSpotlight: Governor Signs Nation's Strongest Law on ‘Suprise' Medical Bills

Read this article as it originally appeared on NJSpotlight.com Advocates for patients, senior citizens, labor unions, and businesses hailed Gov. Phil Murphy’s signing of a complex and controversial measure designed to curb the impact of costly “surprise” medical bills in New Jersey. Supporters said the law, nearly 10 years in the making, is the strongest of its kind nationwide.

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Atlantic City Press: Murphy signs bill to close loopholes in surprise medical bills

Read this article as it originally appeared in The Press of Atlantic City For New Jersey residents who have ever been burdened with "surprise" out-of-network medical bills, a new law signed by Gov. Phil Murphy Friday is meant to better protect patients in the future.

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ROI-NJ: Sarlo, in letter to Muoio, asks N.J. to look into details of health insurance contracts

Read this article as it appeared in ROI-NJ on April 30, 2018 Reining in health care costs continues to be a challenge for many corporations and self-funded plans. The story isn’t any different for the state of New Jersey, the largest employer in the state. State Sen. Paul Sarlo (D-Wood-Ridge) is trying to find new solutions — and potentially hundreds of millions of dollars in savings for the state — by addressing the issue in a different way: Paying closer attention to how the state pays its contracted plan managers.

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ROI-NJ: N.J. doctors worry out-of-network bill won’t control insurance industry abuses

Read this op-ed as it originally appeared on April 18, 2018 in ROI-NJ.  Assembly Speaker Craig Coughlin and state Sen. Joseph Vitale have done a commendable job of highlighting the plight of New Jersey citizens who face “surprise” out-of-network medical bills. This is a devastating crisis, and it is happening every day to thousands of unsuspecting patients around the state. The effect on family finances can be catastrophic.

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The Record: Opinion: Sarlo-Cardinale bill provides real healthcare transparency

Read this article as it originally appeared on northjersey.com One of the most contentious healthcare issues being debated in the Legislature today is “out-of-network” reform. Far too many New Jerseyans have had to deal with surprise — even shocking — medical bills after a surgery or procedure because they were unaware of their insurers’ in-network and out-of-network benefits.

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NJSpotlight: Op-Ed: Out of Network Bill is Insurers' Dream and Middle-Class Nightmare.

Read this article as it originally appeared April 5, 2018 in njspotlight.com As Trenton currently looks to balance the budget, once again it’s our state’s hardest-working citizens who will be left holding the bag. This time, though, it will be the hardworking office and ancillary staff from our small-business private medical practices.

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NJSpotlight: Controversial Insurance Bill Advances Even As Doctors Give Dire Warnings

By Lilo Stainton Read this article as it originally appeared on March 6, 2018 in NJSpotlight. Physicians are ramping up their opposition to the Legislature’s effort to address out-of-network health insurance charges, as they claim the effort would reduce access to treatment and actually end up harming patient care.

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