AN ACT EXEMPTING AMBULATORY SURGICAL CENTERS FROM THE REQUIREMENT TO SUBMIT DEMOGRAPHIC AND CLINICAL DATA, EXTENDING FOR CERTAIN PROVIDERS AND ENTITIES THE DEADLINES FOR MANDATORY PARTICIPATION IN THE STATEWIDE HEALTH INFORMATION EXCHANGE NETWORK KNOWN AS NC HEALTHCONNEX, AND INSTITUTING REFORMS TO PROTECT PATIENTS.
Senate committee substitute to the 2nd edition makes the following changes.
Revises the proposed changes to and further amends GS 90-414.4. Revises the mandatory health information exchange network (HIE Network) participation dates set forth in subsection (a1) as follows. Adds a new provision to subdivision (3), which requires prepaid health plans and LME/MCOs to submit encounter and claims data by specified dates, authorizing the Department of Health and Human Services to submit the required data on behalf of these entities. Revises the proposed changes to subdivision (4), now requiring participation by physicians who perform procedures at ambulatory surgical centers by January 1, 2023 (previously, the 2nd edition eliminated required participation by ambulatory surgical centers, whose deadline was extended from June 1, 2021, in the 1st edition). Makes conforming changes to subsection (b), previously revised to exclude ambulatory surgical centers from the provisions of the subsection, which condition State funding upon twice daily data submissions regarding services rendered to Medicaid and other State-funded health care program beneficiaries and paid for with Medicaid or other State-funded health care funds. Now explicitly requires a physician who performs a procedure at the ambulatory surgical center to be connected to the HIE Network. Deletes proposed new subsection (b1), which prohibited providers or entities whose receipt of State funds is negatively impacted by a failure to connect to the HIE Network and submit required data from balance billing any services rendered to State-funded health care program beneficiaries, and deemed those beneficiaries not responsible for improper charges.
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