Bill Summary for S 137 (2013-2014)

Summary date: 

Apr 24 2013

Bill Information:

View NCGA Bill Details2013-2014 Session
Senate Bill 137 (Public) Filed Tuesday, February 26, 2013
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.
Intro. by Tillman.

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Bill summary

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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