House amendment to the 2nd edition makes the following changes.
Amends GS 90-153.1 to add that chiropractic peer review does not include reviews performed by individuals hired for the purpose of providing expert testimony in or preparing for litigation of personal injury claims.
Summary date: Apr 28 2015 - View summary
Summary date: Apr 27 2015 - View summary
House committee substitute makes the following changes to the 1st edition.
Amends proposed GS 90-153.1 as follows. Limits the applicability of the statute to motor vehicle liability claims for personal injury and to motor vehicle medical payments claims. Removes provisions requiring the review of billing records. Provides that chiropractic peer reviews are also done for the purpose of advising a third party payer as to whether the services rendered were supported by adequate documentation. Adds that chiropractic peer review does not include automated screening programs. Amends the requirements that must be met by the individual performing the peer review to prohibit collecting a fee based on the extent to which the third party payer reduces (was, collecting a fee based on the extent to which the individual recommends a reduction of) the treating chiropractor's bill. Removes the requirement that a person performing a peer review disclose his or her identity and office address to the treating chiropractor.
Changes the act's effective date from when the act becomes law to October 1, 2015, applying to reviews conducted on or after that date.
Amends the act's long title.
Summary date: Apr 15 2015 - View summary
Enacts new GS 90-153.1 to require that when a payor seeks peer review of chiropractic treatment in order to determine whether the services were clinically necessary or whether the charges billed were reasonable (or both), the person conducting the review must hold a current North Carolina license to practice chiropractic and satisfy certain other criteria.
Requires that the standard of care applied be state-specific and that the reviewer disclose his or her identity and office address to the treating chiropractor. A chiropractor licensed by the state may be subject to disciplinary action for failing to comply. An unlicensed person who performs such a review may be subject to criminal and civil enforcement actions.
Effective when the act becomes law.