SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-5311-98T1
IN THE MATTER OF THE
FAILURE BY THE DEPARTMENT
OF BANKING AND INSURANCE
TO TRANSMIT A PROPOSED
DENTAL FEE SCHEDULE TO THE
OAL FOR PUBLICATION IN THE
NEW JERSEY REGISTER
_________________________________________________________________
Argued December 11, 2000 - Decided January 17, 2001
Before Judges Wefing, Cuff and Lefelt.
On appeal from Inaction by New Jersey
Department of Banking And Insurance.
Arthur Meisel argued the cause for
appellants New Jersey Dental Associ-
ation and Harris N. Colton, D.D.S.
Doreen J. Pilligian, Deputy Attorney
General, argued the cause for
respondent New Jersey Department of
Banking and Insurance (John J.
Farmer, Jr., Attorney General,
attorney; Nancy Kaplen, Assistant
Attorney General, of counsel;
Karyn G. Gordon, Deputy Attorney
General, on the brief).
The opinion of the court was delivered by
LEFELT, J.A.D.
This appeal concerns delay by the Department of Banking and
Insurance ("Department") in revising a dental fee schedule, set
forth in N.J.A.C. 11:3-29.6(b), to reflect inflation. The fee
schedule was last revised in 1996 and, according to the New
Jersey Dental Association ("NJDA"), must be adjusted mandatorily,
under N.J.S.A. 39:6A-4.6a, every two years to reflect inflation.
Hoping to force the Department to update the fee schedule, NJDA
filed this appeal from the Department's inaction. NJDA claims it
is entitled to a judgment declaring that the Department shall
"forthwith" adjust the fee schedule upward for inflation; apply
the new rates retroactively to June 30, 1999; and readjust the
fee schedule every two years, with the next adjustment scheduled
for June 30, 2001. We decline to issue the judgment NJDA seeks
and dismiss the appeal, but express dismay with the Department's
progress in complying with the legislative mandate.
I.
The Legislature first enacted N.J.S.A. 39:6A-4.6 in 1988 as
a cost containment measure. P.L. 1988, c. 119, §10. The statute
required the Department to promulgate medical fee schedules on a
regional basis for the purpose of paying health care providers,
including dentists, for services rendered where personal
insurance protection ("PIP") automobile insurance was involved.
In 1990, the Fair Automobile Insurance Reform Act of 1990
("Fair Act"), P.L. 1990, c. 8, was enacted to revise the State's
motor vehicle insurance laws to achieve economy and lower
insurance costs. P.L. 1990, c. 8, §2(d). Through the Fair Act,
the Legislature amended N.J.S.A. 39:6A-4.6 to require, among
other things, that reimbursement rates established within the fee
schedule "incorporate the reasonable and prevailing fees of 75%
of the practitioners within the region," and that the fee
schedule be reviewed biannually (every six months). P.L. 1990,
c. 8, §7. The Fair Act also prohibited health care providers,
including doctors and dentists, from demanding or requesting any
payment in excess of those permitted in the fee schedule. Ibid.
Thus, the fee schedule established maximum reimbursable fees for
services rendered to individuals receiving treatment or goods
under PIP coverage.
On November 26, 1990, in response to the Fair Act, the
Department adopted a medical fee schedule for dental services on
an emergency basis,
22 N.J.R. 3809(a), and published the fee
schedule at N.J.A.C. 11:3-29.6(b). In the six following years,
the dental fee schedule was amended once on August 19, 1996.
28 N.J.R. 3962(a).
The 1996 revision increased the upper limit dollar amounts
of the fee schedule to account for inflationary trends, by
approximately twenty-three to thirty-percent over the 1990
schedule. According to the Department, the amended 1996 dollar
amounts were based on proprietary data consisting of billed fees,
obtained by the Department from the Health Insurance Association
of America.
In 1997, the Legislature again amended N.J.S.A. 39:6A-4.6 by
authorizing the Department to "contract with a proprietary
purveyor of fee schedules for the maintenance of the fee
schedule, which shall be adjusted biennially [every two years]
for inflation and for the addition of new medical procedures."
P.L. 1997, c. 151, §33. When no action was taken concerning the
dental fee schedule after this amendment, on March 11, 1998, NJDA
filed a Notice of Petition for Rulemaking, N.J.A.C. 1:30-3.6,
requesting an increase in the dental fee schedules.
30 N.J.R. 1438(a). The petition indicated that because the last revision
of the schedule occurred on August 19, 1996, to comply with the
1997 amendment, the fee schedule should be revised as of August
19, 1998.
On May 18, 1998, the Department responded to the petition by
indicating that "No exact deadline is imposed on the Commissioner
by the amended statute and the initial two-year compliance period
may be reasonably interpreted to run from [June 30, 1997] the
effective date of the new requirement" rather than from August
19, 1996, the date of the last adjustment.
30 N.J.R. 1866(a).
Meanwhile, one day after the Department responded to the
petitioner's rulemaking petition, on May 19, 1998, the Governor
signed the Automobile Insurance Cost Reduction Act ("AICRA") into
law. P.L. 1998, c. 21 and c. 22. AICRA authorized the
Department to adopt regulations defining, with precision,
standard treatment protocols and diagnostic tests and services
that will be reimbursed under the PIP component of automobile
insurance policies. These regulations, N.J.A.C. 11:3-4, were
adopted in December 1998 and made effective on March 22, 1999.
AICRA intended to reduce costs to the insurance system by
reducing unnecessary insurance company expenses.
On May 15, 1998, almost one year after the effective date of
the 1997 amendment to N.J.S.A. 39:6A-4.6, four days before AICRA
was signed into law, and a few days before the Department
responded to petitioner's rulemaking petition, the Department
issued a Request for Proposal, soliciting bids from contractors
to assist in revising and adjusting the medical fee schedule
regulations. Medicode, Inc., a proprietary purveyor of fee
schedules, submitted a bid proposal to the Department on July 6,
1998. Medicode proposed to revise the existing fee schedules and
create new fee schedules in approximately four months.
On October 20, 1998, the Department accepted Medicode's
proposal and entered into a contract with the corporation. The
Department claims to be working diligently with Medicode, now
called Ingenix, to prepare a proposal for the New Jersey Register
revising the dental fee schedule.
Meanwhile, one day before the Department's Request for
Proposal seeking professional help to revise the fee schedules,
on May 14, 1998, NJDA filed a notice of appeal in the Appellate
Division. This appeal pursued NJDA's position that the
Department must revise the dental fee schedule two years from the
last revision, August 19, 1996. After efforts to accelerate its
appeal failed, however, NJDA withdrew the appeal on August 17,
1998.
With no dental fee schedule revision yet in sight, on March
5, 1999, NJDA wrote to inquire "when the Department expects to
transmit to the Office of Administrative Law a proposed revision
to the Dental Fee Schedule for publication in the New Jersey
Register." The Department responded on April 13, 1999 that it
was "not yet in position to transmit a proposal," but expressed
hope that "this will be accomplished within the next month or
so." When, once again the Department missed its announced
deadline, petitioners filed its second notice of appeal in the
Appellate Division on May 28, 1999.
While this latest appeal was pending, in March 2000, the
Department prepared a discussion draft of the dental fee schedule
and solicited views from various interested parties, including
NJDA. Concern was voiced over the fact that the schedule assumed
that the percentage difference between billed and paid fees was
the same for dentists as it was for other medical providers.
After considering the various comments, the Department decided
not to propose the draft schedule, but instead decided to propose
repeal of the existing dental fee schedule.See footnote 1*
The Department's rule proposal repealing the existing dental
fee schedule and reserving space for a future dental fee schedule
was published by the Office of Administrative Law in the December
18, 2000 New Jersey Register.
32 N.J.R. 4332(a). The proposal
provides that
[t]he Department has determined that it does
not have sufficient data on paid dental fees
to develop a fee schedule at this time. The
current dental fee schedule is being proposed
for repeal. The Department will work with
dental trade organizations and others to
compile a fee schedule that accurately
reflects market-based billed and paid dental
fees.
[
32 N.J.R. 4333.]
Also, under the proposed new rule, the Department defined a
provider's eligible charge or expense to mean "the provider's
usual, customary and reasonable charge or the upper limit in the
fee schedule, whichever is lower." N.J.A.C. 11:3-29.2, proposed
at
32 N.J.R. 4335.
By taking this action, the Department contends that it will
have time to gather data to ascertain the amounts paid for dental
services rather than the amounts actually billed for dental
services in New Jersey so that a proper fee schedule can be
developed. The Department further asserts that its definition of
eligible charge or expense will permit dentists to charge
reasonable amounts for their services that presumably will
reflect the forces of inflation.
Despite this latest development, NJDA takes the position
that "[b]y proposing to repeal the existing dental fee schedule,
the Department is not thereby freed from the continuing duty,
imposed by a positive legislative command, to adjust biennially
for inflation a duly adopted fee schedule while it continues to
exist." Because the Department has only proposed a rule
amendment, and we do not know, at this time, whether the
Department will adopt the proposed repeal of the dental fee
schedule and the definition of eligible charge or expense, we go
further in evaluating NJDA's position.
II.
From the last revision of the fee schedules in 1996 until
the present, the Department claims it has been evaluating AICRA's
legislative reforms as well as changes to the health insurance
market and reviewing a wholesale revision to the regulations
governing all medical fee schedules, including the dental fee
schedule. The Department asserts that once the new baseline
rates are determined for dentists, the rates will incorporate the
effects of inflation and be consistent with the "reasonable and
prevailing fees of 75% of the practitioners within the region."
N.J.S.A. 39:6A-4.6a. The Department has completed and proposed
in the December 18, 2000 Register new fee schedules for
physicians,
32 N.J.R. 4337 - 4357; home care services,
32 N.J.R. 4357; ambulatory services,
32 N.J.R. 4357; and durable medical
equipment and prosthetic devices,
32 N.J.R. 4358 - 4377. The
Department contends, however, that the dental fee schedule needs
further development.
NJDA is frustrated by this lengthy delay where, according to
NJDA, the Department blithely ignores the legislative mandate to
biennially adjust the dental fee schedule. Thus, NJDA seeks
relief by way of mandamus directing the Department to immediately
revise the schedule and commence its biennial updates.
"The exclusive method for review of action or inaction of a
State administrative agency . . . is by direct appeal to us,
pursuant to R. 2:2-3(a)(2)." Trantino v. New Jersey State Parole
Bd.,
296 N.J. Super. 437, 459-60 (App. Div. 1997), aff'd and
modified,
154 N.J. 19 (1998). The term "action" in R. 2:2-
3(a)(2) and R. 2:2-4 "includes inaction." Mathews v. Finley,
46 N.J. Super. 175, 177 (App. Div.), certif. denied sub nom.
Matthews v. Neeld,
25 N.J. 283 (1957). Thus, NJDA correctly
brought its dispute directly to us. Pascucci v. Vagott,
71 N.J. 40, 52 (1976); see also Johnson v. New Jersey State Parole Bd.,
131 N.J. Super. 513, 517-21 (App. Div. 1974), certif. denied,
67 N.J. 94 (1975). Moreover, NJDA followed the correct procedure by
filing a notice of appeal and motion for summary disposition.
Hospital Center at Orange v. Guhl,
331 N.J. Super. 322, 330 (App.
Div. 2000).
Nevertheless, we note that the Department appears to be in
the midst of attempting to revise the dental fee schedule. Given
this case's posture, the relief sought by NJDA is nettlesome
because of separation of powers concerns. N.J. Const. art. III,
§1, ¶1. We must be careful not to intrude upon the agency's
prerogatives. Gilbert v. Gladden,
87 N.J. 275, 281 (1981). This
situation makes mandamus especially problematic for NJDA.
Mandamus is inherently coercive. Mandamus is usually
appropriate only where the right to performance of a ministerial
duty is clear and certain. Vacca v. Stika,
21 N.J. 471, 476
(1956). An official duty is ministerial "when it is absolutely
certain and imperative, involving merely the execution of a set
task, and when the law which imposes it prescribes and defines
the time, mode and occasion of its performance with such
certainty that nothing remains for judgment or discretion." Case
v. Daniel C. Maguire, Inc.,
53 N.J. Super. 494, 498 (Ch. Div.
1959). While the directive usually commands the performance of
a specific act or obligation, mandamus may also compel "the
exercise of a discretionary function." Switz v. Township of
Middletown,
23 N.J. 580, 587 (1957). However, mandamus may not
issue to "control the exercise of discretion." Id. at 587-88.
We cannot micromanage any administrative agency. How an
agency chooses to implement legislation is the agency's primary
responsibility, not the court's. We give agencies wide
discretion in deciding how best to approach legislatively
assigned administrative tasks, Dougherty v. Dep't of Human
Services,
91 N.J. 1, 6 (1982); Texter v. Dep't of Human Services,
88 N.J. 376, 383 (1982), especially when the task falls within a
particular agency's expertise, as does the task in question. See
Public Interest Research Group v. State,
152 N.J. Super. 191, 203
(App. Div.), certif. denied,
75 N.J. 538 (1977).
Obviously, deciding how best to approach and accomplish the
dental fee schedule revision constitutes an exercise of
discretion and is not ministerial. Had the agency not done any
work toward revising the schedule, we could issue mandamus
compelling the Department to begin its work, Switz, supra, 23
N.J. at 587, but any directive, issued at this time, requiring
that the Department complete the task or even directing
completion by a specific time has the potential of interfering
with the orderly workings of the Department. Nevertheless, NJDA
contends that it is merely seeking an order compelling the
Department to do what the Legislature has already required.
III.
Our review of agency determinations is quite limited. We
can overturn only those administrative determinations that are
arbitrary, capricious, unreasonable, or violative of expressed or
implicit legislative policies. Campbell v. Department of Civil
Serv.,
39 N.J. 556, 562 (1963). In this case, NJDA claims the
Department's inaction is violative of N.J.S.A. 39:6A-4.6a.
The statute in issue, in pertinent part, reads as follows:
The Commissioner of Banking and Insurance
shall . . . promulgate medical fee schedules
on a regional basis for the reimbursement of
health care providers providing services or
equipment for medical expense benefits for
which payment is to be made by an automobile
insurer under personal injury protection
coverage . . . or by an insurer under medical
expense benefits coverage . . . . These fee
schedules shall be promulgated on the basis
of the type of service provided, and shall
incorporate the reasonable and prevailing
fees of 75% of the practitioners within the
region. . . . The commissioner may contract
with a proprietary purveyor of fee schedules
for the maintenance of the fee schedule,
which shall be adjusted biennially for
inflation and for the addition of new medical
procedures.
[N.J.S.A. 39:6A-4.6a.]
NJDA claims the Legislature could not have been clearer when
it directed that the fee schedules "shall be adjusted biennially
for inflation." Ibid. NJDA also contends that before opposing
its motion for summary disposition, the Department repeatedly
acknowledged that it had an obligation to adjust the fee
schedules every two years for inflation. Moreover, NJDA points
out that before amending the statute to require biennial
revision, the statute required that the schedules "shall be
reviewed biannually [every six months]." Thus, by amending the
statute to require biennial inflation adjustment, NJDA argues
that the Legislature intended to change the law.
We agree that the plain language of the particular provision
cited by NJDA makes it relatively clear that the Department
should adjust the fee schedules for inflation every two years.
Bergen Commercial Bank v. Sisler,
157 N.J. 188, 202 (1999) (when
interpreting a statute, a court must first look at the wording of
the statute to ascertain its plain meaning and intent); Camden
County Board of Chosen Freeholders v. Keating,
193 N.J. Super. 100, 109 (Law Div.), aff'd,
193 N.J. Super. 111 (App. Div. 1983).
"Our duty is to apply the legislative intent as expressed in the
statute's language." Alston v. City of Camden,
332 N.J. Super. 240, 246 (App. Div.), certif. granted, ___ N.J. ___ (2000).
Indeed, both parties actually agree with the construction of
the limited portion of the statute cited by NJDA. We interpret
the Department's argument that "shall" can be construed as "may"
to permit the Department to recognize that inflationary or
deflationary forces during a two-year period might render
unnecessary a particular adjustment. As so limited, we have no
problem with that interpretation. Thus, we read the parties'
submissions as essentially agreeing that the Legislature intended
all medical fee schedules, including the dental fee schedule, to
be revised for inflation every two years when necessary to
maintain the stated amounts at the seventy-fifth percentile.
Though the parties agree that periodic revisions under the
statute in question must be undertaken, they sharply disagree
over when the Department must begin the revision. Because the
Department revised the schedule only once, in 1996, NJDA believes
that the Department was obligated to adjust the schedule for
inflation every two years after 1996. The Department argues that
the biennial revision schedule does not begin until the
Department issues the revised schedule being developed with
Ingenix's assistance.
The 1997 amendment to N.J.S.A. 39:6A-4.6, requiring biennial
revision, contains no specific directive explaining when the
first inflation adjustment must be begun or completed. "When the
Legislature has concluded that an agency should be required to
take action within a fixed time period, it has incorporated a
specific provision in the applicable legislation establishing a
deadline for agency action." Hospital Center at Orange, supra,
331 N.J. Super. at 335 (citing as examples, N.J.S.A. 52:14B-10(c)
and N.J.S.A. 40:55D-73). In the absence of any deadline, we
conclude that it would be inappropriate in this matter to impose
such a deadline by judicial fiat.
Moreover, the 1997 amendment to N.J.S.A. 39:6A-4.6, provided
that the Department "may contract with a proprietary purveyor of
fee schedules for the maintenance of the fee schedule." The
Legislature also mandated that the schedules "shall be
promulgated on the basis of the type of service provided, and
shall incorporate the reasonable and prevailing fees of 75% of
the practitioners within the region." Thus, the Legislature
understood that some work would have to be undertaken to develop
and maintain the fee schedules and for that purpose it permitted
the Department to engage a "proprietary purveyor."
NJDA contends that in the 1996 revision the Department had
already established baseline rates that incorporate the
reasonable and prevailing fees of seventy-five percent of
practitioners within a region, and, therefore, only an
inflationary adjustment is now required. However, the Department
has indicated, in a valid exercise of discretion, that it had
previously relied on "billed fee data" and would prefer to base
its revised schedule on the more accurate market, or "paid fees."
We normally give "substantial deference to the
interpretation of the agency charged with enforcing an act." New
Jersey Tpk. Auth. v. American Fed. of State, County and Mun.
Employees, Council 73,
150 N.J. 331 (1997) (quoting Merin v.
Maglaki,
126 N.J. 430, 436-37 (1992). In this case, we
acknowledge that the Department's interpretation of the statute
has seemingly changed over the years. At first, the agency took
the position that it had two years from the amendment's effective
date, June 30, 1997, to revise the dental fee schedule. Now, the
Department argues that it can wait until after it promulgates the
new schedule to determine whether any further adjustments are
necessary. Nevertheless, we will overturn an agency's
interpretation of a statute it implements, only when "plainly
unreasonable," Merin v. Maglaki, supra, 126 N.J. at 437, and we
do not view the Department's current interpretation as
unreasonable.
Moreover, both the Fair Act, which established the biennial
revision requirement, and AICRA have cost containment purposes.
When statutes relate to the same or similar subject matter, "we
make every effort to . . . attempt to interpret them
harmoniously." Oches v. Township of Middletown Police Dep't.,
155 N.J. 1, 5 (1998) (citing Laboda v. Township of Clark,
40 N.J. 424, 435 (1963)).
The Department cannot ignore the Legislature's principal
objective of establishing a maximum rate for fee reimbursement
under automobile insurance polices to contain medical expense
costs. Cobo v. Market Transition Facility,
293 N.J. Super. 374,
385 (App. Div. 1996) (quoting
23 N.J.R. 537-38 (Feb. 19, 1991)),
see also N.J.S.A. 39:6A-4.6c. In addition, AICRA, which was
enacted while the Department was working on complying with
N.J.S.A. 39:6A-4.6a, "established typical courses of treatment
for certain common automobile-related injuries." New Jersey
Coalition of Health Care Prof'ls, Inc. v. New Jersey Dep't of
Banking and Ins.,
323 N.J. Super. 207, 224 (App. Div.), certif.
denied,
162 N.J. 485 (1999). The implementing regulations
established "guidelines against which to measure and identify
unnecessary or inappropriate treatment." Ibid. Thus, AICRA
resulted in the promulgation of regulations setting out standard
treatment procedures for which health care providers, including
dentists, would be reimbursed under N.J.A.C. 11:3-29.6. Id. at
274-85.
Any fee schedule that the Department adopts after AICRA,
pursuant to N.J.S.A. 39:6A-4.6a, must of necessity consider and
conform with AICRA's legislative intent, and we cannot conceive
of the Legislature wishing the Department to adjust the existing
schedule for inflation, without considering the cost saving goals
of AICRA. Should medical fees, including dental fees, be
established at too high a level or for unnecessary procedures,
the fundamental goal of AICRA could be impaired.
The amendment to N.J.S.A. 39:6A-4.6, when read together with
AICRA, gives the Department discretion to use its expertise to
contract with a fee schedule purveyor and to calculate and adjust
the fee schedule in accordance with AICRA's overall cost
containment policies. We conclude that biennial adjustment need
not begin until the Department issues a new dental fee schedule
that coordinates the fees that can be charged with the
legislative policy behind AICRA, requiring, among other reforms,
standard treatment procedures to maintain costs.
IV.
When the new schedule is finally issued, NJDA contends that
it should be retroactive to June 30, 1999, two years after the
effective date of N.J.S.A. 39:6A-4.6a. As a general principle,
statutes and regulations are usually applied prospectively.
Seashore Ambulatory Surgery Ctr. v. Dept. of Health,
288 N.J.
Super. 87, 97 (App. Div. 1996). Regulations may be retroactively
applied where "the Legislature has expressed its intent, either
explicitly or implicitly," that they should be so applied, "when
the reasonable expectations of those affected by the
[regulations] warrant such application," or when the regulation
is ameliorative or curative. Twiss v. State, Dept. of Treasury,
124 N.J. 461, 467 (1991); see also Frank A. Greek & Sons, Inc. v.
Township of South Brunswick,
257 N.J. Super. 94, 106 (App. Div.),
certif. denied,
130 N.J. 602 (1992), cert. denied,
507 U.S. 1031,
113 S. Ct. 1848,
123 L. Ed.2d 472 (1993) (citing Gibbons v.
Gibbons,
86 N.J. 515, 522 (1981)). Moreover, a regulation may
only be applied retroactively if such application will not result
in "'manifest injustice' to a party adversely affected."
Gibbons, supra, 86 N.J. at 523; Grippo v. Schrenell & Co.,
223 N.J. Super. 154, 162 (App. Div. 1988).
Neither N.J.S.A. 39:6A-4.6a nor AICRA provides for
retroactive application of the fee schedule, and the prime test
for determining whether a regulation should be applied
retroactively is the intent of the Legislature. Dep't of Envtl.
Protection v. Ventron Corp.,
94 N.J. 473, 498 (1983). Most
significantly, the schedule also affects numerous insurance
companies that are not parties to this appeal, and whether
retroactivity is appropriate cannot be determined until the new
schedule is developed. Because the record is insufficient to
determine this issue, we decline to do so. Accordingly, we leave
this question, initially, to the discretion of the Department.
V.
Thus, we will not issue mandamus to compel the Department to
complete the fee schedule "forthwith." We conclude that the
biennial revision may begin after the new dental fee schedule is
issued. And, we decline to determine whether the new fee
schedule must be retroactive.
We cannot conclude this opinion, however, without
indicating that we are distressed by the Department's apparent
lack of progress in revising the dental fee schedule. Our Supreme
Court has held that undue delay in administrative proceedings may
result in a denial of "fundamental procedural fairness." In re
Arndt,
67 N.J. 432, 436 (1975); Johnson v. New Jersey State
Parole Bd.,
131 N.J. Super. 513, 517-18 (App. Div. 1974), certif.
denied,
67 N.J. 94 (1975).
The progress of the Department in completing this task has
been marked by much unexplained delay. We note, for example,
that N.J.S.A. 39:6A-4.6 was amended in 1997 and the Department
took almost one year before requesting proposals from fee
schedule purveyors. Ingenix's original proposal contemplated
completion within months. Instead, from the date the Department
accepted Ingenix's proposal, to today, over two years have
transpired. In response to a March 5, 1999 inquiry from NJDA,
the Department wrote on April 13, 1999 to express its hope that a
revision of the fee schedule would be "accomplished within the
next month or so." That was over twenty months ago. What is
particularly distressing is that in the Department's proposal to
repeal the existing dental fee schedule, the Department admitted
it still did not have sufficient data to complete the task,
though years have gone by.
We conclude that in the absence of specific deadlines, the
Legislature contemplated reasonable expedition in implementing
the dictates of N.J.S.A. 39:6A-4.6a. We assume that the
Department's implementation effort dealing with AICRA was quite
time consuming, and we commend the Department for completing the
fee schedules for physicians and other providers, but so much
time has transpired, that we wonder whether reasonable efforts
are being undertaken to complete the dental fee schedule. In our
opinion, the Department is pressing upon the limits of
reasonableness, and we urge the Department to speed its efforts
to complete this task.
We also suggest that the Department notify the affected
parties, especially NJDA, should any further delay interfere with
its announced course of action to repeal the existing schedule.
Moreover, the Department should keep all affected parties
informed of its progress with Ingenix in developing the new
schedule after repealing the existing schedule. We further
suggest that such progress not be unnecessarily interrupted and
that the agency proceed with due diligence.
Finally, we take no position on whether the Department's
current proposal to repeal the existing dental fee schedule is an
adequate response toward implementing N.J.S.A. 39:6A-4.6a. That
matter has not been properly presented to us. We do indicate
that whatever action the Department takes should be undertaken
with reasonable dispatch. We do not retain jurisdiction.
Appeal Dismissed.
Footnote: 1 *At oral argument, we granted the Department's motion to supplement the record with additional relevant events that occurred while the appeal was pending.