Bill Summary for S 473 (2013-2014)

Summary date: 

Jul 24 2013

Bill Information:

View NCGA Bill Details2013-2014 Session
Senate Bill 473 (Public) Filed Wednesday, March 27, 2013
A BILL TO BE ENTITLED AN ACT TO AMEND THE PROVISIONS OF HOUSE BILL 834 RELATED TO HEALTH CARE COST REDUCTION AND TRANSPARENCY AND FAIR HEALTH CARE BILLING AND COLLECTIONS PRACTICES; AND TO ALLOW THE SPEAKER OF THE HOUSE AND PRESIDENT PRO TEMPORE OF THE SENATE, AS AGENTS OF THE STATE, TO JOINTLY INTERVENE ON BEHALF OF THE GENERAL ASSEMBLY IN ANY JUDICIAL PROCEEDING CHALLENGING A NORTH CAROLINA STATUTE OR A PROVISION OF THE NORTH CAROLINA CONSTITUTION.
Intro. by Rucho, Brown.

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Bill summary

House committee substitute makes the following changes to the 3rd edition.

Amends the long title.

Amends proposed GS 131E-214.6(b), which requires each hospital, beginning with the quarter ending March 31, 2014, to provide DHHS with specified pieces of information about the 100 most frequently reported admissions by DRG for inpatients, clarifying that they must provide information on the five largest health insurers providing payment to the hospital on behalf of teachers and State employees in addition to insureds (previously, only provided for information  to be submitted on insureds). Adds new language providing that a hospital is not required to report the information required by GS 131E-214.6(b) when the reporting of such information could reasonably lead to the identification of the people that were admitted to the hospital in violation of HIPAA regulations. Changes the date by which the NC Medical Care Commission (Commission) must adopt rules to ensure implementation of this requirement to March 1, 2014 (was, January 1, 2014).

Requires each hospital and ambulatory surgical facility to provide DHHS information on the total costs for the 20 most common surgical procedures and the 20 most common imaging procedures along with related codes beginning with the quarter ending September 30, 2014 (was, June 30, 2014). Provides that information that would lead to the identification of people admitted to the hospital, in violation of HIPAA regulations is not required to be submitted. Requires the Commission to adopt rules to ensure implementation of this requirement by June 1, 2014 (was, March 31, 2014).

Directs the State Health Plan (SHP) for Teachers and State Employees to establish a workgroup to examine the best way to provide teachers and State employees with greater transparency in regards to health services costs under the SHP. Requires the SHP to report the workgroup's findings and recommendations to the Joint Legislative Oversight Committee on Health and Human Services and the Joint Committee on Governmental Operations on or before December 31, 2013, and annually through December 31, 2016.

Directs the Department of Health and Human Services (DHHS) to communicate, not later than September 1, 2013 (was, July 1, 2013), the requirements of Section 2 of the act to all hospitals licensed pursuant to Article 5 of GS 131E and Article 2 of GS 122C, as well as to all ambulatory surgical facilities licensed pursuant to Part 4 of Article 6 of GS 131E.

Amends GS 131E-273 by adding that if a procedure requires a patient's informed consent, the charge for any component of the procedure performed before the consent is given does not exceed the actual cost to the provider if the patient decides not to consent.

Amends GS 131E-91(d)(5), by amending a collection practice that must be used by hospitals and ambulatory surgical facilities to provide that no lien arising out of a judgment for a debt owed a hospital or ambulatory surgical facility under this section must attach to judgment debtors principal resident, or, if the land upon which the residence is located is greater than five acres, then no lien attaches to the residence and the surrounding five acres, held by them as tenants by the entireties.

Enacts new GS 90-413.3A, Required participation in NC HIE for some providers, requiring any hospital, as defined in GS 131E-76(c) and that has an electronic health record system, to connect to the NC HIE and submit individual patient demographic and clinical data on services paid for with Medicaid funds. Also includes three specific findings by the General Assembly which provides the basis for requiring the connection to the NC HIE. Effective January 1, 2014, but will not apply to administrative actions or litigation filed before the effective date.

Provides that new GS 131E-273 does not apply to administrative actions or litigation filed before the December 1, 2013 effective date.

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