A BILL TO BE ENTITLED AN ACT TO PROHIBIT THE REGULAR BUSINESS PRACTICE OF WAIVING REQUIRED MEDICAID AND HEALTH CHOICE RECIPIENT CO-PAYMENTS BY CERTAIN PROVIDERS.
Senate committee substitute makes the following changes to the 1st edition.
Changes long title.
Deletes the entirety of the provisions of the 1st edition.
Enacts new GS 108C-13 (Certain waivers of Medicaid and Health Choice co-payments prohibited), establishing that providers permitted pursuant to GS 90-85.21 or GS 90-85-21A cannot waive the collection of co-payments owed by Medicaid or Health Choice recipients with the intent to induce recipients to purchase, lease, or order items or services from the provider.
A medical provider that does so will be found in violation of this subsection unless the co-payment in question was waived, in full or partially, for any of the following reasons: (1) the waiver is authorized, (2) the provider decides on an individual basis that the collection of the co-payment amount would place a substantial financial hardship on the recipient, (3) the provider has made a good faith effort to collect the co-payment but the reasonable efforts fail, or (4) the provider is a health care facility regulated pursuant to GS Chapter 131E or GS Chapter 122C or is owned or operated by the State.
A violation under this subsection will result in a suspension or termination of the provider's participation in Medicaid and Health Choice.
Effective October 1, 2013, applying to acts committed on or after that date.
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