Bill Summaries: H934 PREVENTIVE CARE AND PAYMENT REFORM ACT.

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  • Summary date: Apr 16 2013 - View Summary

    Amends GS 58-50-130(a)(5), prohibiting insurers from issuing a specific stop-loss policy at an amount less than $60,000 per covered life or any aggregate stop-loss policy to a self-insured small employer with 20 or fewer eligible employees unless the self-insured small employer (1) provides a medical home that provides health care screenings for its employees, (2) is focused on outcomes and key performance indicators, and (3) is reimbursed on an outcomes rather than fee-for-service basis.

    Applies to stop-loss policy contracts entered into, amended, or renewed on or after October 1, 2013.