SARLO LEGISLATION TO REQUIRE REAL-TIME AUDIT OF HEALTH INSURANCE CLAIMS APPROVED BY SENATE

via NJ Senate Democrats

Sent To Governor after Senate Concurrence with Assembly Amendments 

TRENTON – The Senate today approved reform legislation authored by Senate Budget Chair Paul Sarlo (D-Bergen) that will require real-time auditing of billions of dollars in state health insurance claims to prevent overpayments.

The bill, S-3042, also will provide the state with full access to healthcare claims data that the state’s health insurers has withheld as proprietary – data that the state needs to build its own database to analyze healthcare costs and develop future savings.

“This legislation will provide significant cost savings on healthcare costs by assuring real time auditing of the billions of dollars we pay out in claims every year for current and retired teachers and state, county and municipal government employees, and it will do so while providing savings both to public employees and to taxpayers,” said Senator Sarlo.

Previously approved by the Senate, today’s vote concurred with Assembly amendments.  The measure now goes to the governor.

“I have been pushing for a bifurcated system with an independent Third Party Administrator that would clearly separate the claims adjudication process from the health insurance provider network. This is the system that was recommended by the bipartisan Economic and Fiscal Policy Workgroup that I co-chaired and by the Governor’s task force on healthcare reform. The Administration, however, was only willing to go as far as a real-time third party audit, so that is what we did.”

By gaining full access to claims data that the health insurance provider networks had previously deemed proprietary, the state government will have a chance to fully analyze the principal drivers of healthcare costs and create a better plan design that will provide cost savings year after year.

“One of the most important provisions of this bill is that it will guarantee that the state will have ownership and access to all health insurance claims data,” Senator Sarlo said. “As both Treasury and the public employee unions have recognized, this data is vital to analyzing healthcare costs and redesigning our public employee and retiree healthcare system in future years to maximize savings.”

The legislation is patterned after the Pharmacy Benefits Manager program that the Legislature created in 2016 that saved hundreds of millions of dollars by providing real -time auditing of pharmaceutical bills.

The vote was 36-1.

SENATE APPROVES SARLO-& SINGLETON ACES BILL TO INCREASE DIVERSITY IN SCIENCE & TECHNOLOGY EDUCATION

via NJ Senate Democrats

Trenton – Students from underserved communities that are underrepresented in STEM fields would be provided with greater educational opportunities to prepare themselves for New Jersey’s innovation economy through a new program created by legislation authored by Senator Paul Sarlo and Senator Troy Singleton that was approved by the Senate today.

The bill, S-3685, would create the “ACES” scholarship program to broaden opportunities by “Accessing Careers in Engineering and Science.”

“Expanding opportunities for underserved students to gain the knowledge and skills in science and technology will help advance New Jersey’s innovation economy,” said Senator Sarlo, who chairs the Senate Budget Committee. “The ACES program will provide exposure to science and technology disciplines with an emphasis on hands-on experience. It will open doors of opportunity where they can excel.”

The innovative program would be modelled after a successful effort at the Stevens Institute of Technology. In its first year, Stevens experienced a 60 percent increase in underrepresented minority participation in precollege STEM summer programs.

“Exposure to the sciences and technology through STEM programs will set this generation up for success in the future,” said Senator Singleton (D-Burlington). “However, we must ensure that this opportunity exists for all of our students, especially those who have been traditionally underrepresented in this field. By creating the ACES program for these high school students, we are expanding their access to the innovation economy.”

Students who participate would be required to be a member of an underserved community or a member of a group that is underrepresented in the STEM fields. An initial investment of $750,000 and rising to $2.5 million annually after four years, matched with institution and private sector funding, the program would produce 200 high school students and 100 college graduates per year.

The ACES Program would consist of a residential pre-college summer program for selected high school students who attend a partner high school and an undergraduate ACES Scholar program.

Under the bill, the Secretary of Higher Education would select up to seven public or independent research universities in New Jersey.

The bill was approved by the Senate with a vote of 37-0.