§ 26:2S-1 Short title
§ 26:2S-2 Definitions relative to health care quality
§ 26:2S-3 Form to be filed by carrier; minimum information required
§ 26:2S-4 Disclosure of terms and conditions in writing to subscriber
§ 26:2S-5 Additional disclosure requirements
§ 26:2S-5.1 Health insurance carriers to provide organ, tissue donation information to subscribers
§ 26:2S-6 Designation of licensed physician as medical director for managed care
§ 26:2S-6.1 Managed care plan to pay full contractual rate to out-of-network provider, direct payments, certain circumstances
§ 26:2S-6.2 Waiver of health insurance copayments for certain active duty military and their families
§ 26:2S-7 Review of application for participation
§ 26:2S-7.1 Universal application for credentialing physicians for a carrier’s provider network
§ 26:2S-7.2 Acceptance of application by carriers
§ 26:2S-7.3 Rules, regulations
§ 26:2S-8 Establishment of policy governing removal of health care providers
§ 26:2S-9 Contract terms concerning appropriate medical care
§ 26:2S-9.1 Managed care plan, continuing treatment of certain patients by physician no longer employed by plan; required
§ 26:2S-9.2 Written fee schedule information furnished to health care providers, proprietary information
§ 26:2S-9.3 Violations, penalty
§ 26:2S-10 Offer of point-of-service plan, terms
§ 26:2S-10.1 Home treatment for bleeding episodes associated with hemophilia, required coverage
§ 26:2S-10.2 Clinical laboratory services at outpatient regional hemophilia care center, required coverage
§ 26:2S-10.3 Regulations by department
§ 26:2S-10.4 Optometrist not required to participate in certain plans
§ 26:2S-10.5 Contract between carrier and vision care provider, fees permissible
§ 26:2S-10.6 Vision care provider, choice of sources, providers
§ 26:2S-10.7 Definitions relative to optometrists, vision care plans
§ 26:2S-10.8 Definitions relative to insurance coverage for mental health conditions and substance use disorders
§ 26:2S-10.9 Regulations for benefits carrier relative to prescription drug benefits
§ 26:2S-11 Independent Health Care Appeals Program
§ 26:2S-12 Contract to conduct appeal reviews; procedures
§ 26:2S-13 Immunity from civil liability for participants in Independent Health Care Appeals Program
§ 26:2S-14 Report to Legislature, Governor
§ 26:2S-14.1 General hospital to provide information concerning the Independent Health Care Appeals Program
§ 26:2S-14.2 Size, content, format of notice
§ 26:2S-14.3 Rules, regulations
§ 26:2S-15 Compliance with department reporting requirements
§ 26:2S-15.1 Annual report to carrier by managed behavioral health care organization
§ 26:2S-16 Violations, penalties
§ 26:2S-17 Recommendations for legislative action
§ 26:2S-18 Enforcement; rules, regulations
§ 26:2S-18.1 Publication of annual financial statements
§ 26:2S-19 Findings, declarations relative to Managed Health Care Consumer Assistance Program
§ 26:2S-20 Definitions relative to Managed Health Care Consumer Assistance Program
§ 26:2S-21 Managed Health Care Consumer Assistance Program
§ 26:2S-22 Report to Governor, Legislature
§ 26:2S-23 Immunity from liability
§ 26:2S-24 Appropriations; fees, use
§ 26:2S-25 Rules, regulations
§ 26:2S-26 Definitions relative to certain dental benefit plans
§ 26:2S-27 Covered services
§ 26:2S-28 Rules, regulations
§ 26:2S-29 Carrier offering a health benefits plan to provide coverage, payment
§ 26:2S-30 Definitions regarding dental plan application forms
§ 26:2S-31 Adoption of dental plan application forms
§ 26:2S-32 Acceptance of universal dentist application
§ 26:2S-33 Adoption of regulations
§ 26:2S-34 Preexisting condition provision prohibited in health benefits plan
§ 26:2S-35 Imposition of limits prohibited
§ 26:2S-36 Provision of emergency, urgent services
§ 26:2S-37 Insurance plans to cover prescription refills during state of emergency
§ 26:2S-38 Prescription drug benefit carrier contracts, opioid antidote coverage
§ 26:2S-39 Health benefit plans, coverage for abortion, certain religious employers exempt
§ 26:2S-40 Carrier to ensure provision of comprehensive behavioral health crisis intervention services coverage
§ 26:2SS-1 Short title
§ 26:2SS-2 Findings, declarations relative to out-of-network health care charges
§ 26:2SS-3 Definitions relative to out-of-network health care charges
§ 26:2SS-4 Disclosures by health care facility
§ 26:2SS-5 Disclosures by health care professional relative to participation in health benefits plans
§ 26:2SS-6 Website updates of addition, deletion of provider from carrier’s network
§ 26:2SS-7 Billing for emergency, urgent care
§ 26:2SS-8 Coverage for inadvertent out-of-network emergency services
§ 26:2SS-9 Responsibilities of carrier relative to inadvertent out-of-network services
§ 26:2SS-10 Payment disputes, binding arbitration
§ 26:2SS-11 Payment disputes for member of self-funded plan, binding arbitration
§ 26:2SS-12 Listing of arbitrations on website
§ 26:2SS-13 Notice of protections provided
§ 26:2SS-14 Calculation of savings; reports
§ 26:2SS-15 Violations, inducements
§ 26:2SS-16 Annual audit of managed care plan
§ 26:2SS-17 Violations; penalties
§ 26:2SS-18 Rules, regulations
§ 26:2SS-19 Severability
§ 26:2SS-20 Construction of act

Terms Used In New Jersey Statutes > Title 26 > Chapter 2S - Health Care Quality Act

  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Fraud: Intentional deception resulting in injury to another.
  • Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
  • Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. Source: FDIC
  • Oversight: Committee review of the activities of a Federal agency or program.
  • person: includes corporations, companies, associations, societies, firms, partnerships and joint stock companies as well as individuals, unless restricted by the context to an individual as distinguished from a corporate entity or specifically restricted to one or some of the above enumerated synonyms and, when used to designate the owner of property which may be the subject of an offense, includes this State, the United States, any other State of the United States as defined infra and any foreign country or government lawfully owning or possessing property within this State. See New Jersey Statutes 1:1-2
  • population: when used in any statute, shall be taken to mean the population as shown by the latest Federal census effective within this State, and shall be construed as synonymous with "inhabitants. See New Jersey Statutes 1:1-2
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • State: extends to and includes any State, territory or possession of the United States, the District of Columbia and the Canal Zone. See New Jersey Statutes 1:1-2