The New Jersey No Fault Act provides that every standard automobile insurance policy shall contain personal injury protection (PIP) benefits that include the payment of medical expenses up to $250,000 per person per accident. N.J.S.A. 39:6A-4. In addition, the act requires the Commissioner of Banking and Insurance to promulgate a medical fee schedule for the reimbursement of health care providers for services and equipment that incorporate “the reasonable and prevailing fees of 75% of the practitioners within the region.” N.J.S.A. 39:6A-4.6. Also, the act requires the commissioner to designate an organization for the purpose of administering proceedings for the resolution of disputes regarding the recovery of medical expense benefits. N.J.S.A. 39:6A-5.1.
On July 8, 2011, the Department of Banking and Insurance (DOBI) filed proposed new rules, amendments and repeals with respect to PIP benefits, PIP dispute resolution and PIP medical fee schedules. The department commented that the proposal is reasonable and appropriate “to revise the regulatory framework for the provision and payment of PIP benefits to contain costs and thereby increase the value of the PIP benefit to injured persons.” DOBI requested that all written comments be submitted by Sept. 30, 2011.
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