OCEAN TOWNSHIP - This week, Senator Vin Gopal introduced legislation temporarily banning insurance companies from auditing healthcare-related claims during the COVID-19 state of emergency in order to make sure patients can receive the accessible and affordable care they need, while also protecting hospitals from devoting additional staff efforts toward processing paperwork rather than caring for patients.
This bill would implement a statewide moratorium on all healthcare insurance audits, administrative denials, and technical denials of claims until the Governor lifts the current coronavirus-related state of emergency. Under this bill, insurance companies would also be unable to retroactively deny coverage for coronavirus-related care based on medical necessity even after the state of emergency has ended.
“Right now, thousands of patients and families are struggling to care for sick relatives and loved ones, at a time when hospitals are also struggling to keep enough staff to care for a sudden flood of coronavirus-positive patients,” said Gopal (D-Long Branch). “It’s unreasonable and inhumane to expect these families and hospitals to spend precious resources dealing with bureaucratic paperwork and expensive insurance denials when our state is pulling out all the stops to stop this virus.
“When this state of emergency comes to an end, we can’t let patients go broke just because a treatment they thought was lifesaving didn’t meet an insurance company’s standards in combating COVID-19. We need all hands on deck, which means that we can’t afford to play by the normal rules of bureaucracy and business-as-usual. If someone is sick, their insurance company needs to pay for their treatment - with no excuses.”