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Prudent Layperson Standard Advances In New Jersey

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NU Online News Service, Dec. 4, 4:30 p.m. – Committees in both houses of the New Jersey state legislature have approved a bill that would require health insurers and health maintenance organizations to use the “prudent layperson” definition of a medical emergency.

Carriers would have to use the definition when deciding whether to accept emergency health services claims.

The bill defines an emergency as an acute condition whose symptoms are severe enough to cause a patient or caretaker to reasonably seek immediate medical assistance, due to serious jeopardy to the individual’s health or serious impairment to bodily functions or bodily organs or parts.

The definition also includes symptoms such as severe pain, psychiatric disturbance and symptoms of substance abuse.

The bill was sponsored in the Assembly as A. 2829 by Assemblywomen Joan M. Quigley, D-Jersey City, and Loretta Weinberg, D-Teaneck, and in the state Senate by Sen. Joseph Vitale, D-Woodbridge, as bill S. 9.