New Jersey Lawmakers Cap Self – Pay Charges

Uninsured New Jersey patients will soon be seeing lower hospital charges. Earlier this week, New Jersey’s governor signed into law Assembly Bill 2609, which caps the fees that hospitals can charge uninsured patients. According to the New Jersey Commission on Rationalizing Health Care Resources, the constraints contained in this new law will cause a decrease in the hospital bills of most uninsured patients.

While the New Jersey Department of Health and Senior Services still must develop the specific monetary caps, we know the following:

  • The law only protects uninsured patients whose gross family incomes are equal to or less than 500% of the federal poverty level.
  • Department of Health and Senior Services will develop a sliding scale maximum fee schedule that will be based on the patient’s gross family income.
  • The maximum hospital fees for protected, uninsured patients will be 115% or less of the respective Medicare fee schedule charges.
  • The fee caps will be established for both in-patient and out-patient services.

As a point of reference, 500% of the federal income poverty level is presently about $70,000 for a married couple (no dependent children). The amount for a married couple with two dependent children is approximately $106,000. Therefore, most New Jersey residents would be protected by these caps.

Finally, it’s important to note that this law does not affect non-hospital self-pay charges. Therefore, non-hospital based physicians need not adjust their self-pay fee schedules in response to this law.

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