A Capehart Scatchard Blog

New Jersey Bans Medical Providers From Charging Claimants for Work-Related Medical Expenses

By on November 21, 2012 in Uncategorized with 1 Comment

New Jersey, like many states, has had an ongoing problem with physicians and hospitals that balance bill injured workers for work-related care.  This problem has become more acute in the age of managed care reductions where medical providers dispute the amount they are paid and then send invoices to injured workers for the unpaid balance.  In response to this widespread problem, Governor Christopher Christie signed into law Assembly No. 2652 on November 19, 2012.  It is now known as P.L.2012, c.67.

The law reads as follows:

Fees for treatments or medical services that have been authorized by the employer or its carrier or its third party administrator or determined by the Division of Workers’ Compensation to be the responsibility of the employer, its carrier or third party administrator, or have been paid by the employer, its carrier or third party administrator pursuant to the workers’ compensation law, R.S. 34:15-1 et seq., shall not be charged against or collectible from the injured worker.

In addition, the law vests within the Division of Workers’ Compensation exclusive jurisdiction of any disputed medical charge arising from any claim for compensation for a work-related injury or illness.  This means that providers and hospitals who dispute charges arising from workers’ compensation care cannot sue civilly or use other means to collect on such charges.  The matter must be decided within the Division of Workers’ Compensation, which has well-established procedures for such medical reimbursement claims.  In fact, there are several thousand medical reimbursement claims currently being handled by the New Jersey Division of Workers’ Compensation.

The law goes on to state that “the treatment of an injured worker or the payment of workers’ compensation to an injured worker or dependent of an injured or deceased worker shall not be delayed because of a claim by a medical provider.”

This law makes good sense for all stakeholders in workers’ compensation.  The past practice of balance billing injured workers for authorized care caused tremendous anxiety for workers and their families.  For employers the law will eliminate a very inefficient system of permitting medical providers to sue in civil court for medical charges arising from workers’ compensation.  That practice alone led to procedural nightmares for employers and carriers as well as excessive legal costs.

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About the Author

About the Author:

John H. Geaney, a shareholder and co-chair of Capehart Scatchard's Workers' Compensation department, began an email newsletter entitled Currents in Workers’ Compensation, ADA and FMLA in 2001 in order to keep clients and readers informed on leading developments in these three areas of law. Since that time he has written over 500 newsletter updates.

Mr. Geaney is the author of Geaney’s New Jersey Workers’ Compensation Manual for Practitioners, Adjusters & Employers. The manual is distributed by the New Jersey Institute for Continuing Legal Education (NJICLE). He also authored an ADA and FMLA manual as distributed by NJICLE. If you are interested in purchasing the manual, please contact NJICLE at 732-214-8500 or visit their website at www.njicle.com.

Mr. Geaney represents employers in the defense of workers’ compensation, ADA and FMLA matters. He is a Fellow of the College of Workers’ Compensation Lawyers of the American Bar Association and is certified by the Supreme Court of New Jersey as a workers’ compensation law attorney. He is one of two firm representatives to the National Workers’ Compensation Defense Network. He has served on the Executive Committee of Capehart Scatchard for over ten (10) years.

A graduate of Holy Cross College summa cum laude, Mr. Geaney obtained his law degree from Boston College Law School. He has been named a “Super Lawyer” by his peers and Law and Politics. He serves as Vice President of the Friends of MEND, the fundraising arm of a local charitable organization devoted to promoting affordable housing.

Capehart Scatchard is a full service law firm with offices in Mt. Laurel and Trenton, New Jersey. The firm represents employers and businesses in a wide variety of areas, including workers’ compensation, civil litigation, labor, environmental, business, estates and governmental affairs.

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There is 1 Brilliant Comment

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  1. Theresa says:

    Hello!
    If the worker’s compensation insurance denies a claim due to non-compliance of the employ, and the employer says that they are not responsible to pay; who is responsible for payment?
    Thanks

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