Bill Summary for S 744 (2011-2012)

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Summary date: 

Apr 20 2011

Bill Information:

View NCGA Bill Details2011-2012 Session
Senate Bill 744 (Public) Filed Tuesday, April 19, 2011
Intro. by Goolsby.

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Bill summary

Enacts new Part 8, Reporting of Group Claims Information to Employers, to Article 50 of GS Chapter 58. Provides that an employer is entitled to claim information for its employee group health plan from its health benefits provider, including information covering the 36 months prior to the employer’s request, as specified in six provisions. Provides additional details concerning certain information requested by the employer. Specifies that an employer is entitled to request and receive information under Part 8 up to two years after termination of the contract with the health care benefits provider. Defines “protected health information” as the term is defined in the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Directs a health care benefits provider to provide the required information within 30 days of the employer’s request, as detailed. Prohibits a health care benefits provider from disclosing protected health information if the health insurance issuer is prohibited from disclosing the information under any state or federal law that imposes more stringent privacy restrictions than HIPAA. Requires that the issuer notify the plan, plan sponsor, or plan administrator that the information is being withheld, and provide the plan, plan sponsor, or plan administrator categories of claim information that the issuer determined are subject to more stringent privacy restrictions, if the issuer withholds information. Specifies that a health care benefits provider is not required to provide a report more than twice in a 12 month period. Allows employers to request additional information from the health care benefits provider, as specified. Authorizes governmental entities to request reports from health care benefits providers; states that these reports are confidential and not a public record. Clarifies that a health care benefits provider issuer that releases information, including protected health information, under Part 8 does not violate a standard of care and is not civilly or criminally liable. Specifies the penalty for failure to comply with Part 8. Effective October 1, 2011.