More than 3 million New Jersey residents enrolled in state-regulated health plans now have the right to sue their HMOs, under provisions of the so-called patients’ bill of rights signed by Acting Gov. Donald T. DiFrancesco on July 30, 2001.
New Jersey is the ninth state to enact such a law, formally known as the Health Care Accountability Act. It is separate from the federal patients’ bill of rights currently being considered by Congress.
The state law grants New Jersey residents covered by state-regulated health plans the right to sue if their insurers’ decisions to deny or delay medical treatment result in serious physical or mental harm.
The new legislation does not apply to the 2.7 million New Jersey residents insured by employer-provided plans, which are regulated by the federal government.
The bill was strongly opposed by the New Jersey Association of Health Plans, which argued New Jersey already had a binding appeals process that it said significantly reduced the need for the ability to sue.
The New Jersey patients’ rights bill is more strict than some versions of the federal bill, says Kevin Israel, an aide to Assemblyman Steven Corodemus (R- Monmouth County), who cosponsored the legislation.
The New Jersey law creates a two-tiered system for resolving complaints. The most serious claims, asserting an HMO’s decision to delay or deny care resulted or could result in “serious or significant” harm, such as death or paralysis, go straight to court.
Daniel Beers writes for Insure.com.