Attorney Meiron Barnadav in the New Jersey in US
Meiron Bar-nadav: New Jersey has multiple healthcare insurance laws in place to protect New Jersey residents and healthcare insurance providers from fraud and from possibly suffering physically or mentally from a lack of healthcare insurance.
New Jersey has two state-sponsored health insurance programs in place to cover the needs of all citizens that do not receive health insurance from their employers or from government assistance. These programs, known as the Individual Health Coverage Program (IHC) and the Small Employer Health Benefit Program (SEH) cover all individuals who qualify under those circumstances, regardless of age, sex, current health and medical history. In 1992, N.J.S.A. 17B:27A-3 was enacted to create these programs.
The Individual Health Coverage Program (IHC) ensures that people who do not receive health insurance through their jobs or government assistance can purchase it from one of the state's approved private carriers. Purchasers can get health insurance for themselves and for their families through this program. A wide variety of coverage plans are available to New Jersey residents who purchase this plan. These include indemnity plans, managed care plans, and B&E plans. Choosing the best plan for him or herself and his or her family is the responsibility of the purchaser.
The Small Employer Health Benefits Program (SEH) was created to allow small businesses to have access to group health benefits for their employees. Under this law, all employers must have access to group health plans regardless of their industry and must also be able to renew that coverage every year, no matter what health or personal circumstances change for their employees. Small group participation requirements, provisions related to purchasers' preexisting conditions, and any other factors related to health benefits are restricted by this program. All members and their dependents may continue their coverage event after they become ineligible for the group plan.
Through the years since they were created, there have been many changes to these programs made through amendments to N.J.S.A. 17B:27A-3. The most recent changes were made in January 2014 to keep these programs in line with recent changes to healthcare insurance laws at the state and national levels.
The Federal Consolidated Omnibus Reconciliation Act, COBRA, is a program that allows employees and their dependents to continue to receive healthcare insurance after they retire, divorce or separate from the insured employee, age out of €dependent€ status, or have their hours reduced to part-time work. COBRA is only available to employers with 20 or more employees. If an employee wants to take advantage of his or her COBRA benefits, he or she must accept the coverage within two months of his or her employer offering it.
In 2004, the New Jersey Mandated Health Benefits Advisory Commission was created. This Act required all proposed mandated health benefits to be reviewed by a team of financial and medical experts. If a healthcare insurance mandate passes this commission's review, it may be signed into law. The commission operates under the New Jersey Department of Health, a state-run agency that works to promote health and safety in New Jersey.
The aforementioned programs are in place to provide healthcare coverage for New Jerseyans who are at risk of not receiving healthcare benefits. In most cases, these programs are completely beneficial to the working people who support them. But when an individual commits an act of healthcare insurance fraud, he or she hurts everybody who uses the system honestly. Fortunately, these are multiple healthcare insurance fraud laws in place to minimize the damage that fraudsters can inflict on New Jersey's healthcare system.
The New Jersey Healthcare Claims Fraud Act, N.J.S.A. 2C:21-4.2 and N.J.S.A. 2C:21-4.3, was enacted to attach a definition and appropriate penalty to the crime of healthcare fraud. Under this law, it is illegal for a healthcare professional or a patient to submit a claim to an insurance company for a medical service that he or she did not provide or receive.
New Jersey's Medicaid fraud law, N.J.S.A. 30:4D-17, states that it is illegal for any individual to seek and obtain any Medicaid assistance that he or she is not entitled to receive. Recipients of Medicaid benefits are also barred from seeking compensation for services they did not receive.
N.J.S.A. 17:33A is the general insurance fraud law. This act groups healthcare insurance fraud with other types of insurance fraud, such as homeowner's or automobile insurance. No matter what type of insurance claim is used to defraud a provider, insurance fraud is theft, which is an indictable crime in New Jersey.
If you have been accused of healthcare insurance fraud or want to learn more about the statutes that govern healthcare benefits in New Jersey, call Ron Bar-Nadav at 201-525-1555 to discuss your questions. Ron Bar-Nadav can help you learn more about your rights and your legal options. Don't wait to educate yourself about your case - the best defense is a proactive offense. Call today to start arming yourself with the facts.
New Jersey has two state-sponsored health insurance programs in place to cover the needs of all citizens that do not receive health insurance from their employers or from government assistance. These programs, known as the Individual Health Coverage Program (IHC) and the Small Employer Health Benefit Program (SEH) cover all individuals who qualify under those circumstances, regardless of age, sex, current health and medical history. In 1992, N.J.S.A. 17B:27A-3 was enacted to create these programs.
The Individual Health Coverage Program (IHC) ensures that people who do not receive health insurance through their jobs or government assistance can purchase it from one of the state's approved private carriers. Purchasers can get health insurance for themselves and for their families through this program. A wide variety of coverage plans are available to New Jersey residents who purchase this plan. These include indemnity plans, managed care plans, and B&E plans. Choosing the best plan for him or herself and his or her family is the responsibility of the purchaser.
The Small Employer Health Benefits Program (SEH) was created to allow small businesses to have access to group health benefits for their employees. Under this law, all employers must have access to group health plans regardless of their industry and must also be able to renew that coverage every year, no matter what health or personal circumstances change for their employees. Small group participation requirements, provisions related to purchasers' preexisting conditions, and any other factors related to health benefits are restricted by this program. All members and their dependents may continue their coverage event after they become ineligible for the group plan.
Through the years since they were created, there have been many changes to these programs made through amendments to N.J.S.A. 17B:27A-3. The most recent changes were made in January 2014 to keep these programs in line with recent changes to healthcare insurance laws at the state and national levels.
The Federal Consolidated Omnibus Reconciliation Act, COBRA, is a program that allows employees and their dependents to continue to receive healthcare insurance after they retire, divorce or separate from the insured employee, age out of €dependent€ status, or have their hours reduced to part-time work. COBRA is only available to employers with 20 or more employees. If an employee wants to take advantage of his or her COBRA benefits, he or she must accept the coverage within two months of his or her employer offering it.
In 2004, the New Jersey Mandated Health Benefits Advisory Commission was created. This Act required all proposed mandated health benefits to be reviewed by a team of financial and medical experts. If a healthcare insurance mandate passes this commission's review, it may be signed into law. The commission operates under the New Jersey Department of Health, a state-run agency that works to promote health and safety in New Jersey.
The aforementioned programs are in place to provide healthcare coverage for New Jerseyans who are at risk of not receiving healthcare benefits. In most cases, these programs are completely beneficial to the working people who support them. But when an individual commits an act of healthcare insurance fraud, he or she hurts everybody who uses the system honestly. Fortunately, these are multiple healthcare insurance fraud laws in place to minimize the damage that fraudsters can inflict on New Jersey's healthcare system.
The New Jersey Healthcare Claims Fraud Act, N.J.S.A. 2C:21-4.2 and N.J.S.A. 2C:21-4.3, was enacted to attach a definition and appropriate penalty to the crime of healthcare fraud. Under this law, it is illegal for a healthcare professional or a patient to submit a claim to an insurance company for a medical service that he or she did not provide or receive.
New Jersey's Medicaid fraud law, N.J.S.A. 30:4D-17, states that it is illegal for any individual to seek and obtain any Medicaid assistance that he or she is not entitled to receive. Recipients of Medicaid benefits are also barred from seeking compensation for services they did not receive.
N.J.S.A. 17:33A is the general insurance fraud law. This act groups healthcare insurance fraud with other types of insurance fraud, such as homeowner's or automobile insurance. No matter what type of insurance claim is used to defraud a provider, insurance fraud is theft, which is an indictable crime in New Jersey.
If you have been accused of healthcare insurance fraud or want to learn more about the statutes that govern healthcare benefits in New Jersey, call Ron Bar-Nadav at 201-525-1555 to discuss your questions. Ron Bar-Nadav can help you learn more about your rights and your legal options. Don't wait to educate yourself about your case - the best defense is a proactive offense. Call today to start arming yourself with the facts.
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