{"data":{"id":"us-nj/n.j.-stat.-17-48g-4","jurisdiction":"us-nj","citation":"N.J. Stat. § 17:48G-4","heading":"Inapplicability of act relative to certain decisions of insurers, third party administrators.","body":"7.\tThis act shall not be construed:\na.\tTo 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;\nb.\tTo regulate insurers' or third party administrators' use of a protocol for denying or limiting benefit payments for dental services where the protocol:\n(1)\thas 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\n(2)\tdoes not involve evaluation of an individual patient's dental care or condition; or\nc.\tTo regulate the application of contract limitations and exclusions, the credentialing of dentists or the conduct of retrospective fraud reviews.\nL.2007, c.259, s.7.","path":["TITLE 17 CORPORATIONS AND INSTITUTIONS FOR FINANCE \t\t\tAND INSURANCE"],"source_url":"https://pub.njleg.state.nj.us/statutes/STATUTES-TEXT.zip","current_through":"P.L.2025, c.405, and J.R.22","vintage":"","retrieved_at":"2026-08-27T17:54:13Z","sha256":"91e1b97e5ec87debb3e4b835522f96dde93ec6b29af01ab66f12165873df8040","source_id":"us-nj","stale":true,"prev":"us-nj/n.j.-stat.-17-48g-3","next":"us-nj/n.j.-stat.-17-48g-5"},"notice":"GroundRules: Original legal text. Not legal advice."}