N.J. Eyes Capping Doctors’ Charges for Auto Accident Patients

January 3, 2007

New Jersey regulators are considering limiting how much doctors can charge insurers for treating people injured in vehicle accidents, a move meant to cut prices but one foes argue will make it hard to get medical care.

The state Department of Banking and Insurance proposal would restrict how much medical professionals can charge for more than 1,000 procedures associated with auto accidents. Doctors say they may sue to stop the change.

Michael Kornett, chief executive officer of the Medical Society of New Jersey, said blocking the price controls is the group’s top priority for the year.

“It’s very dramatic,” said Mark Manigan, a Roseland attorney who represents Alliance for Quality Care and Orthopedic Surgeons of New Jersey, both of which oppose the price caps.

New Jersey drivers pay the nation’s highest auto insurance premiums, and most policies come with generous medical benefits. Injured motorists usually have little problem getting treatment for accident injuries because there are few limits on what insurers can pay doctors for their services.

But regulators and insurers contend preset prices will help discourage fraud and rein in costs in a state where the average accident-related medical claim is $10,776 — nearly twice the national average, according to a recent study by the Property Casualty Insurers Association of America.

“Higher-than-average medical costs, due to higher charges billed for medical facilities, medical professionals and certain diagnostic treatments, are a major factor driving New Jersey’s high cost of auto insurance,” said analyst Diana Lee, author of the study.

The new caps may be imposed in the coming months, state officials said.

A recent survey by the National Association of Insurance Commissioners found New Jersey drivers paid an average of $1,221 for coverage in 2004.

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