Opposition to NJ A1952 & S1285 – Attack on Out of Network Physicians

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Letter to NJ GOP Senators

Re: Opposition to A1952/S1285

Dear Honorable Senator,

As General Counsel for the Association of American Physicians & Surgeons, I alert you to an ominous threat to patients and the free market in our New Jersey state legislature. Several Democrat legislators have introduced A1952/S1285, which is price-control legislation to unfairly target life-saving physicians. It would place outlandish price controls on the amount that out-of-network physicians may charge insurance companies, in direct violation of free market principles.

Currently, insurance companies should pay out-of-network physicians the bills that physicians submit for medically necessary care, so that the patient is not held responsible for the “balance bill.”  Insurance companies often refuse to pay their bills, however.  In the State of Texas, insurance companies acting as administrators for third party plans are generally responsible for paying the physician his charged fees, and the insurance climate in Texas has been relatively smooth and well-functioning, far better as compared with here in New Jersey.

The proposed legislation would undoubtedly impact patient care adversely, by inappropriately linking insurance issues to medical care when a patient is sick in the hospital.  The bill would often delay vital clinical care, endangering the patient’s health and life.  The legislation would be unenforceable in medically urgent circumstances, when patients should not have to make decisions about their medical care based upon insurance issues in violation of the federal Emergency Medical Treatment & Labor Act (EMTALA).  The bill would also be unenforceable as it would additionally interfere with the professional relationships between hospitals and physicians, and also with the professional relationships between private practitioner physicians themselves.

It is essential for the benefits of the free market and the continued provision of charity care that physicians not be subjected to arbitrary price controls for the benefit of insurance companies.  The physician needs to be able to bill insurance companies the value of his services, especially when these are primarily life-protective.  The ability for a physician to remain available for charity care depends on this.  Price-fixing is bad medicine for everyone.

We respectfully urge you, on behalf of physicians and patients, to vigorously oppose this proposed price control by Democrats and to prevent any attempt by them to undermine patient care, the U.S. Constitution, or the free market.  Thank you.

Sincerely,

Andrew L. Schlafly
General Counsel
Association of American Physicians & Surgeons

Letter to NJ Democrat Senators

Re: Opposition to A1952/S1285

Dear Honorable Senator,

As General Counsel for the Association of American Physicians & Surgeons, I alert you to an ominous threat to patients in proposed New Jersey state legislation. Several legislators have introduced A1952/S1285, which is price-control legislation to unfairly target life-saving physicians. It would place outlandish price controls on the amount that out-of-network physicians may charge insurance companies, thereby jeopardizing charity care.

Currently, insurance companies should pay out-of-network physicians the bills that physicians submit for medically necessary care, so that the patient is not held responsible for the “balance bill.”  Insurance companies often refuse to pay their bills, however.  In the State of Texas, insurance companies acting as administrators for third party plans are generally responsible for paying the physician his charged fees, and the insurance climate in Texas has been relatively smooth and well-functioning, far better as compared with here in New Jersey.

The proposed legislation would undoubtedly impact patient care adversely, by inappropriately linking insurance issues to medical care when a patient is sick in the hospital.  The bill would often delay vital clinical care, endangering the patient’s health and life.  The legislation would be unenforceable in medically urgent circumstances, when patients should not have to make decisions about their medical care based upon insurance issues in violation of the federal Emergency Medical Treatment & Labor Act (EMTALA).  The bill would also be unenforceable as it would additionally interfere with the professional relationships between hospitals and physicians, and also with the professional relationships between private practitioner physicians themselves.

It is essential for the continued provision of charity care that physicians not be subjected to arbitrary price controls for the benefit of insurance companies.  The physician needs to be able to bill insurance companies the value of his services, especially when these are primarily life-protective.  The ability for a physician to remain available for charity care depends on this.  Price fixing is bad medicine for everyone.

We respectfully urge you, on behalf of physicians and patients, to vigorously oppose this proposed price control and to prevent any attempt to undermine patient care or the U.S. Constitution.  Thank you.

Sincerely,

Andrew L. Schlafly
General Counsel
Association of American Physicians & Surgeons

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