Chiaravalloti Introduces “Patient Protection Act” Bill

Measure Aims to Educate Consumers on Hospital Transfers Prior to the Process,

Protect From Surprise Billing

            (TRENTON) – Recognizing the anxiety and unexpected financial liabilities that can occur when a patient is transferred to an out-of-state health care facility, Assembly Deputy Parliamentarian Nicholas Chiaravalloti introduced a measure on Monday to help educate patients about such transfers and available options before they take place.

            “To ensure that health care consumers are able to make well informed health care decisions, patients should be informed of their right to select the facility in which they receive their care before being transferred to another state,” said Chiaravalloti (D-Hudson). “Patients should have all the information about why they are being transferred, and their financial responsibilities associated with the transfer–only then can a patient make an informed choice.”
The measure, the “Patient Protection Act” (A-5369) establishes a number of consumer protections that mandate health care professionals, before obtaining consent to transfer a patient to an out-of-state health care facility, to provide the patient with simple, written information concerning their rights. The bill applies to all health care facilities and professionals licensed in the state, with the exception of pediatric services. The health care professional would need to notify a patient, and document in the patient record, regarding the following:

1. The patient’s right to receive care at a facility of choice;
2. Clinical rational for the out-of-state transfer;
3. Location of the out-of-state facility;
4. Availability of clinically appropriate services at nearby New Jersey facilities;
5. The nature of the relationship if the patient is being transferred or referred to an affiliated facility; and
6. In instances of trauma, an explanation as to why the patient is not being transferred to a Level 1 or Level 2 Trauma center in New Jersey.

            The measure would also require licensed health care professionals to notify a patient’s health insurance carrier or self-funded health benefits plan sponsor prior to transferring the patient to an out-of-state health care facility.

            “A well-informed patient is in a better position to make better decisions and be better protected from unexpected costs and inconveniences—especially as it pertains to hospital transfers,” said Chiaravalloti. “But a patient can’t make a sound medical decision when they don’t have this information before the transfer takes place.”

            The Act also stipulates that facilities establish and maintain communication between the patient and the health insurance carrier or self-funded health benefits plan sponsor to inform the patient about the network status of the out-of-state facility or provider, and any out-of-pocket costs for which the patient would be responsible.

 “This type of communication is necessary to help the patient understand whether specific services are covered under their health benefits plan and the estimated out-of-pocket costs to be incurred because of the out-of-state transfer,” said Chiaravalloti.

            The measure now awaits further review by the Assembly Speaker.