New Jersey
Title 17B — Insurance · Chapter 30
75 entries
§
17B:30-1. Declaration of purpose
§
17B:30-2. Practices prohibited
§
17B:30-3. Misrepresentations and false advertising of policies or annuity contracts
§
17B:30-4. False information and advertising
§
17B:30-5. False financial statements
§
17B:30-6. "Twisting" prohibited
§
17B:30-7. Defamation
§
17B:30-8. Boycott, coercion and intimidation
§
17B:30-9. Stock operations and advisory board contracts
§
17B:30-10. Stock acquisition, common management
§
17B:30-11. Interlocking directorate
§
17B:30-12 Discrimination prohibited; terms defined.
§
17B:30-13. Rebates and special inducements
§
17B:30-13.1. Unfair claim settlement practices
§
17B:30-13.2. Record of complaints
§
17B:30-14. Exceptions to discrimination and rebates
§
17B:30-15. Enumeration of acts not exclusive
§
17B:30-16. Commissioner's powers of investigation
§
17B:30-17. Desist orders for prohibited practices; penalty
§
17B:30-18. Procedures as to undefined practices
§
17B:30-19. Appeal by intervenor
§
17B:30-20. Violation of cease and desist order; penalty
§
17B:30-21. Provisions of chapter additional to existing laws
§
17B:30-22. Immunity from prosecution
§
17B:30-23 Timetable for implementation of electronic receipt, transmission of health care claim information; standard forms.
§
17B:30-24 Regulations.
§
17B:30-25 Thomas A. Edison State College to study, monitor effectiveness of electronic data interchange technology, electronic health records.
§
17B:30-26 Definitions relative to payment of health and dental insurance plans.
§
17B:30-27 Applicability.
§
17B:30-28 Provision of information.
§
17B:30-29 Provision of toll-free telephone number.
§
17B:30-30 Maintenance of claims records; audit required.
§
17B:30-31 Additional record of claims.
§
17B:30-32 Overdue capitation payment.
§
17B:30-33 Regulations.
§
17B:30-34 Inapplicability of act.
§
17B:30-34.1 Health care provider, carrier, more than one method of payment, reimbursement; definitions.
§
17B:30-35. Definitions relative to standardized pharmacy identification cards
§
17B:30-36. Issuance of standardized pharmacy identification information, card to primary insured
§
17B:30-37. Exceptions for issuance of card
§
17B:30-38. Provision of new pharmacy identification card
§
17B:30-39. Rules, regulations
§
17B:30-40 Definitions, construction, regulations on notice of premium increase to employers.
§
17B:30-41 Findings, declarations relative to collection of unpaid hospital accounts.
§
17B:30-42 Definitions relative to collection of unpaid hospital accounts.
§
17B:30-44 "New Jersey Hospital Care Payment Fund."
§
17B:30-45 Authority of department.
§
17B:30-46 Decisions of department constitute final agency action.
§
17B:30-47 Procedures for participating hospitals.
§
17B:30-55 Violations, penalties; rules, regulations.
§
17B:30-55.1 Short title.
§
17B:30-55.2 Findings, declarations.
§
17B:30-55.3 Definitions.
§
17B:30-55.4 Payer, information, utilization management, processing, payment of claims.
§
17B:30-55.5 Payer, respond, hospital, health care provider request, prior authorization.
§
17B:30-55.6 Carrier, respond, prior authorization requests, medication coverage submitted, NCPDP SCRIPT Standard for ePA transactions.
§
17B:30-55.7 Prior authorization, chronic, long-term care condition, validity, exception, timeline.
§
17B:30-55.8 Prior authorization, denial, limitation imposed by payer, physician, scope of actions.
§
17B:30-55.9 Prior authorization, defined number, discrete services, set time frame, validity, exception.
§
17B:30-55.10 Payer to honor prior authorization granted to covered person by previous payer, initial coverage, upon receipt of documentation.
§
17B:30-55.11 Denial of prior authorization, communicated via written communication agreed to by payer, hospital, health care provider.
§
17B:30-55.12 Adverse determinations, appeal, reviewed by physician.
§
17B:30-55.13 Payer shall not deny reimbursement, hospital, health care provider in compliance, circumstances,
§
17B:30-55.14 Payer, reimbursement according to provider contract, medically necessary emergency, urgent care covered under plan.
§
17B:30-55.15 Failure by payer to comply with deadline, health care services subject to review, automatic authorization.
§
17B:30-55.16 Statistics available regarding prior authorization approvals, denials, website.
§
17B:30-55.17 Liberal construction.
§
17B:30-56 Rules, regulations.
§
17B:30-57 Liberal construction.
§
17B:30-58 Definitions relative to reimbursement for certain ambulance services.
§
17B:30-59 Assignment of benefits to service provider of right to receive reimbursement for ambulance service.
§
17B:30-60 Definitions relative to certain dental provider networks.
§
17B:30-61 Third party access.
§
17B:30-62 Inapplicability.
§
17B:30-63 Rules, regulations.