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New Jersey Statutes, Title: 17, CORPORATIONS AND INSTITUTIONS FOR FINANCE AND INSURANCE

    Chapter 48g:

      Section: 17:48g-4: Inapplicability of act relative to certain decisions of insurers, third party administrators.

          
7. This act shall not be construed:

a. To regulate insurers' or third party administrators' making any decision, including, but not limited to, a decision concerning benefit or insurance coverage, that does not involve the making of a dental decision;

b. To regulate insurers' or third party administrators' use of a protocol for denying or limiting benefit payments for dental services where the protocol:

(1) has been approved for use by a dentist who is duly licensed in this State or who has been issued a limited registration certificate pursuant to section 4 of this act; and

(2) does not involve evaluation of an individual patient's dental care or condition; or

c. To regulate the application of contract limitations and exclusions, the credentialing of dentists or the conduct of retrospective fraud reviews.

L.2007, c.259, s.7.



This section added to the Rutgers Database: 2013-06-10 16:36:30.






Older versions of 17:48g-4 (if available):



Court decisions that cite this statute: CLICK HERE.