Bill Summary for H 395 (2021-2022)
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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.Intro. by Sasser, Potts, K. Baker, Wray.
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Senate amendments amend the 3rd edition as follows.
Amendment #1 adds subsection (b1) to GS 90-414.4 prohibiting in-network providers or entities providing health services under contract with the State Health plan who are not connected to the HIE Network from billing the State Health Plan or a plan member more than they would be billed if the provider were connected to the HIE Network. Prohibits balance billing because the provider or entity did not connect to the HIE Network.
Amendment #2 changes the date by which the HIE Advisory Board must report to the Joint Legislative Oversight Committee on Health and Human Services to March 1, 2022 (was, December 1, 2022). The amendment also adds language to do the following:
(1) Direct the HIE Authority, the State Health Plan Division, and the Division of Health Benefits to identify all providers required to connect to the HIE Network as a requirement for receiving State funds, those providers who have not connected to the HIE Network, and providers whose deadline to connect to the HIE Network is approaching or has passed;
(2) Direct the HIE Authority to contact providers identified and ascertain the status of their connection to the HIE Network;
(3) Direct the HIE Authority to share with providers information about the Statewide Health Information Exchange Act and how to connect to the HIE Network;
(4) Direct licensing authorities overseeing providers required to connect to the HIE Network to provide contact information of licensees when that information is not readily available to the HIE Authority, Department of State Treasurer, or Department of Health and Human Services;
(5) Direct the Department of State Treasurer, Department of Health and Human Services, and licensing authorities to provide contact information of providers on or before November, 1, 2021;
(6) Direct the State Health Plan to provide claim encounter data to support the HIE Authority’s report and fulfill responsibilities to operate the State Health Plan Division by November 1, 2021; and
(7) Direct the State Health Plan Division to use and disclose claim payment data as needed to satisfy the HIE Authority’s reporting requirement.