New Jersey legislation · 2026-2027 Regular Session
New Jersey A5685: Health insurance carriers-concerns administrative fees or penalties
Status: In committee, October 19, 2026
Prohibits health insurance carriers from assessing administrative fees or penalties on in-network health care facilities for providing inadvertent out-of-network services.
What the bill says
An Act concerning certain administrative fees or penalties for care involving out-of-network health care providers and supplementing P.L.2018, c.32 (C.26:2SS-1 et seq.).
From the introduced text, October 19, 2026:
An Act concerning certain administrative fees or penalties for care involving out-of-network health care providers and supplementing P.L.2018, c.32 (C.26:2SS-1 et seq.). Be It Enacted by the Senate and General Assembly of the State of New Jersey: 1. a. A carrier shall not assess an administrative fee or penalty on an in-network health care facility that provides inadvertent out-of-network services to a covered person. b. A violation of subsection a. of this section by a carrier shall be considered an unfair trade practice pursuant to N.J.S.17B:30-1 et seq. and shall be subject to penalties contained pursuant to N.J.S.17B:30-17. 2. This act shall take effect on the 90th day next following the date of enactment and shall apply to policies and contracts issued, executed, delivered, or renewed on or after the date of enactment. STATEMENT This bill prohibits health insurance carriers from assessing administrative fees or penalties on in-network health care facilities that provide inadvertent out-of-network services to covered persons. Under existing law, "inadvertent out-of-network services" means health care services that are: covered under a managed care health benefits plan that provides a network; and provided by an out-of-network health care provider in the event that a covered person utilizes an in-network health care facility for covered health care services and, for any reason, in-network health care services are unavailable in …
Sponsors
- John V. Azzariti Jr., M.D. (R, 39) · primary sponsor
- Margie Donlon, M.D. (D, 11) · primary sponsor
Latest actions
- : INT 1RA REF AFI
Subjects: HEALTH - FACILITIES, INSURANCE - HEALTH INSURANCE
Common questions
- What is A5685?
- A5685 is a bill in the New Jersey Legislature (2026-2027 Regular Session): Health insurance carriers-concerns administrative fees or penalties.
- What does A5685 do?
- In its own words: An Act concerning certain administrative fees or penalties for care involving out-of-network health care providers and supplementing P.L.2018, c.32 (C.26:2SS-1 et seq.).
- What is the status of A5685?
- In committee as of October 19, 2026. Latest action: INT 1RA REF AFI (October 19, 2026).
- Who sponsored A5685?
- John V. Azzariti Jr., M.D. (R, 39), with 1 co-sponsor.
- Where is the official record for A5685?
- On the New Jersey Legislature website: https://www.njleg.state.nj.us/bill-search/2026/A5685
Source: official New Jersey record. Tracked by Delilah, AI for legislation across all 50 states and Congress.