Out-of-state care provision removed by Sweeney on pension/benefit reform

TRENTON – State Sen. President Steve Sweeney (D-3), of West Deptford, is moving a separate bill to repeal part of his not-yet-passed pension and benefit reform legislation.

The provision in question is regarding the ability of public employees to receive care at out-of-state health facilities. The new language was hammered out by staff representing Sweeney, Gov. Chris Christie – including Chief of Staff Rich Bagger, Treasurer Andrew Sidamon-Erastoff – and Assembly Speaker Sheila Oliver (D-34), of East Orange, this morning. It “clarifies legislative intent and ensures employee choice in getting the best care,” according to a Senate Majority press release.

The clause has come under scrutiny with accusations that it would benefit South Jersey insurance broker George Norcross III, who is also chairman of Cooper Union hospital in Camden. The removal of the provision was first reported on PolitickerNJ this morning, and is the second clause removed by Sweeney after critical review. The first clause was a moratorium on entrants to the State Employee Health Benefits Plan, which was also seen as beneficial to Norcross, in his position as CEO of Conner Strong insurance brokerage.

Sweeney said in the release today, “This legislation will ensure that we are able to live up to our goals of keeping more of our health care dollars in New Jersey while not eliminating the choices that are so important to employees and their families. This is the right thing to do.”

Under the new legislation, the entirety of Section 76 of the pending pensions and health benefits reform legislation (S-2937/A-4133) would be repealed. It would be replaced by language that would direct the new health care boards to create insurance plans that would specifically include only in-state providers, and other plans that would include coverage for out-of-state providers. No employee would be forced to choose the in-state option.

Subscribers to the in-state plan would be allowed to seek out-of-state care on their physician’s certification that no qualified provider exists in-state who can care for the patient’s condition – as with the original language, primary and emergency care would be exempted. Subscribers to the in-state plan who currently see an out-of-state specialist also would have that relationship grandfathered.

Sweeney said the legislation will be placed immediately on second reading in the Senate and voted on today in conjunction with the broader reform bill.

Oliver said the Assembly Budget Committee will take up the legislation today, with the goal of voting both measures on Thursday.

Out-of-state care provision removed by Sweeney on pension/benefit reform