Establishes reference-based pricing system for certain medical services.

This New Jersey bill requires health insurance companies to offer a reference-based pricing system for specific medical services, directly affecting patients and healthcare providers. Under this system, insurers would pay providers a pre-determined maximum rate for certain procedures instead of the full amount billed, with the goal of controlling costs on services that currently have the largest gaps between Medicare rates and negotiated rates. The law mandates that insurers provide customers with an annual list of covered services, their set prices, and the providers who have agreed to accept these rates, while also ensuring patients have reasonable access to care. The Department of Banking and Insurance is tasked with creating detailed rules to implement this pricing framework and monitor network adequacy.