N.J.S.A. 17:48G-4 — Inapplicability of act relative to certain decisions of insurers, third party administrators.

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 is the verbatim text of N.J.S.A. 17:48G-4, retrieved from the New Jersey Legislature's public statute corpus. Statutes are amended periodically — for the most current version, check the external source link above. Kyzer is not a law firm and this page is not legal advice.