New Jersey Legislature (healthcare bills) · October 19, 2026 · Primary source
NJ A 5685: Prohibits health insurance carriers from assessing administrative fees or penalties on in-network health care facilities for providing inadvertent out-of-network services.
Summary
New Jersey Assembly Bill 5685, introduced and referred to the Assembly Financial Institutions and Insurance Committee, would prohibit health insurance carriers from imposing administrative fees or penalties on in-network health care facilities when those facilities provide inadvertent out-of-network services. The bill targets insurer-side financial penalties directed at participating providers. No hearing date or companion Senate bill is identified in the available record.
What this may mean
If enacted, the bill restricts New Jersey-licensed health insurance carriers from assessing certain fees and penalties against in-network facilities for out-of-network service situations the facility did not deliberately create. In-network hospitals and facility-based providers in New Jersey would face reduced financial exposure from carrier clawback or penalty mechanisms tied to inadvertent out-of-network billing events.
Informational only. Not legal, medical, financial, or other professional advice. Always consult a qualified professional familiar with your specific facts before relying on any item.
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