Prohibits downcoding in health insurance claims.

This New Jersey bill (A 238) prohibits health insurance payers from downcoding claims to reduce payments to healthcare providers. It directly affects providers (like doctors and hospitals) and insurers by requiring payers to reimburse for the actual service performed, not a lower-cost code. The law bans adjusting claims to "less complex or lower cost service" codes to cut payments, defining downcoding as using remark codes to downgrade claims. It applies to all health insurance carriers, health maintenance organizations, and their agents operating in New Jersey. The Department of Banking and Insurance will create implementing regulations.