Reduces statute of limitations from six years to two years in medical fee disputes in workers' compensation matters.

A1384

ASSEMBLY, No. 1384

STATE OF NEW JERSEY

222nd LEGISLATURE

�

PRE-FILED FOR INTRODUCTION IN THE 2026 SESSION

Sponsored by:

Assemblywoman ELLEN J. PARK

District 37 (Bergen)

SYNOPSIS

���� Reduces statute of limitations from six years to two
years in medical fee disputes in workers' compensation matters.

CURRENT VERSION OF TEXT

���� Introduced Pending Technical Review by Legislative
Counsel.

��

An Act
concerning the statute of limitations for medical fee
disputes in workers� compensation matters and amending R.S.34:15-15.

����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:

���� 1.��� R.S.34:15-15 is amended
to read as follows:

���� 34:15-15.� The employer shall
furnish to the injured worker such medical, surgical and other treatment, and
hospital service as shall be necessary to cure and relieve the worker of the
effects of the injury and to restore the functions of the injured member or
organ where such restoration is possible; provided, however, that the employer
shall not be liable to furnish or pay for physicians' or surgeons' services in
excess of $50.00 and in addition to furnish hospital service in excess of
$50.00, unless the injured worker or the worker's physician who provides
treatment, or any other person on the worker's behalf, shall file a petition
with the Division of Workers' Compensation stating the need for physicians' or
surgeons' services in excess of $50.00, as aforesaid, and such hospital service
or appliances in excess of $50.00, as aforesaid, and the Division of Workers'
Compensation after investigating the need of the same and giving the employer
an opportunity to be heard, shall determine that such physicians' and surgeons'
treatment and hospital services are or were necessary, and that the fees for
the same are reasonable and shall make an order requiring the employer to pay
for or furnish the same.� The mere furnishing of medical treatment or the
payment thereof by the employer shall not be construed to be an admission of
liability.

���� If the employer shall refuse
or neglect to comply with the foregoing provisions of this section, the
employee may secure such treatment and services as may be necessary and as may
come within the terms of this section, and the employer shall be liable to pay
therefor; provided, however, that the employer shall not be liable for any
amount expended by the employee or by any third person on the employee's behalf
for any such physicians' treatment and hospital services, unless such employee
or any person on the employee's behalf shall have requested the employer to
furnish the same and the employer shall have refused or neglected so to do, or
unless the nature of the injury required such services, and the employer or the
superintendent or foreman of the employer, having knowledge of such injury
shall have neglected to provide the same, or unless the injury occurred under
such conditions as make impossible the notification of the employer, or unless
the circumstances are so peculiar as shall justify, in the opinion of the
Division of Workers' Compensation, the expenditures assumed by the employee for
such physicians' treatment and hospital services, apparatus and appliances.

���� All fees and other charges for
such physicians' and surgeons' treatment and hospital treatment shall be
reasonable and based upon the usual fees and charges which prevail in the same
community for similar physicians', surgeons' and hospital services.

���� When an injured employee may
be partially or wholly relieved of the effects of a permanent injury, by use of
an artificial limb or other appliance, which phrase shall also include
artificial teeth or glass eye, the Division of Workers' Compensation, acting
under competent medical advice, is empowered to determine the character and
nature of such limb or appliance, and to require the employer or the employer's
insurance carrier to furnish the same.

���� Fees for medical, surgical,
other treatment, or hospital services that have been authorized by the employer
or its carrier or its third party administrator or determined by the Division
of Workers' Compensation to be the responsibility of the employer, its carrier
or third party administrator, or have been paid by the employer, its carrier or
third party administrator pursuant to the workers' compensation law,
R.S.34:15-1 et seq., shall not be charged against or collectible from the
injured worker.� Exclusive jurisdiction for any disputed medical charge arising
from any claim for compensation for a work-related injury or illness shall be
vested in the division.�
For services rendered on or after the effective
date of P.L.��� , c.��� (pending before the Legislature as this bill), a
dispute shall be filed with the Division of Workers� Compensation no later than
two years after the date that any payment or notice of denial of payment was
received.
� The treatment of an injured worker or the payment of workers'
compensation to an injured worker or dependent of an injured or deceased worker
shall not be delayed because of a claim by a medical provider.

���� No provider to the injured
worker of medical, surgical, other treatment, or hospital service pursuant to
the workers' compensation law, R.S.34:15-1 et seq., shall report any portion of
their charges which are alleged to be unpaid, to any collection or credit
reporting agency, bureau, or data collection facility until: (1) a judge of
compensation within the Division of Workers' Compensation has fully adjudicated
the rights and liabilities of all parties, including the rights of the claimant
for payments pursuant to this section, section 1 of P.L.1953, c.207
(C.34:15-15.1), and section 1 of P.L.1966, c.115 (C.34:15-15.2), regarding the
payment of these charges; or (2) a notice of a stipulation settlement or an
order approving settlement regarding the payment of these charges has been
filed with the court.� Upon a finding that non-compliance with this paragraph
has occurred, a judge of compensation, in summary fashion, and in addition to
such other provisions under the workers' compensation law, R.S.34:15-1 et seq.,
may:

���� a.���� order the
non-compliant� provider to retract the medical, surgical, other treatment, or
hospital service charges reported to the collection or credit reporting agency,
bureau, or data collection facility;

���� b.��� impose a fine on the
non-compliant� provider, not to exceed $5,000, payable to the Second Injury
Fund;

���� c.���� order the non-compliant
provider to pay a reasonable counsel fee in connection with a claimant for
payments who has suffered damage to credit rating due to the reporting of
unpaid medical, surgical, other treatment, or hospital service charges to a
collection or credit reporting agency, bureau, or data collection facility;

���� d.��� order the non-compliant�
provider to take such steps as are necessary, within 30 days of the order, to
rehabilitate the credit record of a claimant, with a showing made to the court
of the efforts made in that regard; and

���� e.���� order the non-compliant
provider to pay an award of damages to the claimant not to exceed 25 percent of
the medical, surgical, other treatment, or hospital service charges reported by
the non-compliant� provider to the collection or credit reporting agency,
bureau, or data collection facility, the minimum award being $350.00.

(cf: P.L.2019, c.416, s.1)

���� 2.��� This act shall take
effect immediately.

STATEMENT

���� This bill provides that the
statute of limitations for a medical fee dispute in a workers� compensation
matter will be two years from the date that a payment or notice of denial of
payment was received by a claimant.� The current statute of limitations for
these matters, as interpreted by State courts, is six years from the date that
a payment or notice of denial of payment was received by a claimant.