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Read. Follow. Verify.New Jersey bill regulates out-of-network medical billing, requires cost disclosures, and creates dispute resolution panels
Last action · January 13, 2026: Introduced, Referred to Assembly Financial Institutions and Insurance CommitteeSponsor: Auth, Robert
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What This Bill Would Do
Assembly Bill 504 requires health care providers and facilities to disclose their network status and estimated costs before non-emergency procedures, bans for emergency services, and establishes peer review panels to resolve billing disputes.
Patients facing unexpected medical bills can dispute charges exceeding $500 through newly established state peer review programs, while providers and insurers must update network disclosures and claims data transparency.
- Surprise out-of-network billing occurs when patients receive emergency or ancillary medical services from providers who do not participate in their health insurance plan's network, often resulting in unexpected out-of-pocket charges. context
- Assemblyman Robert Auth represents New Jersey's 39th Legislative District in the General Assembly. context
Who It Would Affect
Groups the bill's text would affect if enacted, as described in the record. Being affected is not a position for or against it.
Health care consumers
Consumers receive mandatory disclosures regarding provider network status and cost estimates, gain protections against surprise emergency bills, and obtain access to a peer review process for billing disputes.
Physicians and non-participating physicians
Physicians must provide network disclosures, written cost estimates, and ancillary provider information, and are subject to peer review determinations on balance billing and medical necessity.
Health care facilities
Facilities must disclose network and pricing information prior to non-emergency procedures, provide written warnings regarding out-of-network ancillary staff, and participate in dispute resolution programs.
Carriers and third party administrators
Insurers and administrators must update online network directories within 20 days of changes, provide network lists to employers and providers, and issue written notices of consumer protections.
Key Facts
You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.
Frequently Asked Questions
What happens if I receive emergency care from an out-of-network doctor at a hospital?
When can I request a peer review for a disputed medical bill?
What information must physicians provide before scheduling a non-emergency procedure?
What else do you want to know?
News Coverage
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Votes, people, money & the original sourceWhere This Stands
Currently in committee. The next step in the legislative lifecycle is Floor Vote.
Procedural history
1 action- Jan 13, 2026HouseIntroducedIntroduced, Referred to Assembly Financial Institutions and Insurance Committee
Version history
Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.
View official text →Lobbying Activity
No state lobbying filings in our records match this bill. Federal lobbying reports (LDA) cover Congress, so they are not listed on state bills.
Full breakdown
Who this bill affects and the strongest case for and against it, written only from the bill’s own text.
Sponsors
Discoveries
Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.
Establishment of Dual Peer Review Programs
The legislation creates two distinct peer review programs—one for physicians within the State Board of Medical Examiners and another for health care facilities overseen by the Department of Banking and Insurance—to resolve balance billing disputes independently of traditional arbitration.
Connected Entities
Sources
njleg.state.nj.us
Analysis Score
0–100- Significance85How much this matters to a regular citizen
- Controversy65Intensity of disagreement among stakeholders
- Entertainment10Compellingness for a non-policy-wonk reader
- Buzz40Current news / social attention level
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