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A 3257

Prohibits health insurance carriers from making certain changes to contract with network providers during term of contract.

2026-2027 Regular Session Introduced by Dan Hutchison and 2 co-sponsors

Prohibits health insurers from reducing a network provider’s reimbursement during the contract term, ensuring term stability for negotiated rates.

Introduced, Referred to Assembly Financial Institutions and Insurance Committee
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Bill Summary · A 3257

Bill Summary – A 3257 (Session 222, New Jersey)

Title

Prohibits health insurance carriers from making certain changes to contracts with network providers during the term of the contract.

Purpose and Intent

The bill aims to protect providers from unilateral contract changes by health insurance carriers that would reduce provider reimbursement during the contract term. It seeks to ensure price and compensation terms agreed upon in a contract with network providers remain stable for the duration of the contract.

Key Provisions

  • Prohibition on mid-term reductions: A health insurance carrier may not make any change to a contract with a network provider that would reduce the provider’s reimbursement during the term of that contract.
  • Effective date and applicability: The act takes effect on the first day of the third month after enactment and applies to contracts entered into or renewed on or after that effective date.

Who is Affected

  • Health insurance carriers operating in New Jersey that contract with network providers (e.g., physicians, hospitals, and other providers within provider networks).
  • Network providers whose contracted reimbursement terms would be protected against mid-term reductions.
  • Potential indirect impact on patients by maintaining contract stability and predictability in provider reimbursement terms, which could influence network behavior and negotiated rates.

Procedural and Timeline Details

  • Introduced: January 13, 2026
  • Committee: Referred to Assembly Financial Institutions and Insurance Committee
  • Sponsors: Primary sponsors include Co-sponsors Heather Simmons, Dan Hutchison, and Cody Miller
  • Effective date: First day of the third month after enactment
  • Scope of applicability: Contracts that are entered into or renewed on or after the effective date of the act

Potential Impact and Considerations

  • Provider protections: Strengthens protections against retroactive or mid-term fee reductions, contributing to contract stability and predictability for network providers.
  • Carrier considerations: May limit agility in adjusting reimbursement terms within contract periods, potentially affecting rate renegotiations or performance-based changes during a contract term.
  • Market effects: Could influence negotiation dynamics between carriers and providers, with possible downstream effects on network offerings and patient access.

Note: The bill’s text provides a straightforward prohibition on mid-term reimbursement reductions, with limited additional provisions beyond the effective date and applicability.

Compiled from official sources — confirm details with the bill’s official record.

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