Bill Summaries: H395 HIE DEADLINE EXTENSION & PATIENT PROTECTION. (NEW)

Tracking:
  • Summary date: May 27 2021 - More information

    AN ACT EXEMPTING AMBULATORY SURGICAL CENTERS FROM THE REQUIREMENT TO SUBMIT DEMOGRAPHIC AND CLINICAL DATA, EXTENDING FOR CERTAIN PROVIDERS AND ENTITIES THE DEADLINES FOR MANDATORY PARTICIPATION IN THE STATEWIDE HEALTH INFORMATION EXCHANGE NETWORK KNOWN AS NC HEALTHCONNEX, AND INSTITUTING REFORMS TO PROTECT PATIENTS. SL 2021-26. Enacted May 27, 2021. Effective May 27, 2021.


  • Summary date: May 20 2021 - More information

    Senate amendments amend the 3rd edition as follows.

    Amendment #1 adds subsection (b1) to GS 90-414.4 prohibiting in-network providers or entities providing health services under contract with the State Health plan who are not connected to the HIE Network from billing the State Health Plan or a plan member more than they would be billed if the provider were connected to the HIE Network. Prohibits balance billing because the provider or entity did not connect to the HIE Network.

    Amendment #2 changes the date by which the HIE Advisory Board must report to the Joint Legislative Oversight Committee on Health and Human Services to March 1, 2022 (was, December 1, 2022). The amendment also adds language to do the following:
    (1) Direct the HIE Authority, the State Health Plan Division, and the Division of Health Benefits to identify all providers required to connect to the HIE Network as a requirement for receiving State funds, those providers who have not connected to the HIE Network, and providers whose deadline to connect to the HIE Network is approaching or has passed;
    (2) Direct the HIE Authority to contact providers identified and ascertain the status of their connection to the HIE Network;
    (3) Direct the HIE Authority to share with providers information about the Statewide Health Information Exchange Act and how to connect to the HIE Network;
    (4) Direct licensing authorities overseeing providers required to connect to the HIE Network to provide contact information of licensees when that information is not readily available to the HIE Authority, Department of State Treasurer, or Department of Health and Human Services;
    (5) Direct the Department of State Treasurer, Department of Health and Human Services, and licensing authorities to provide contact information of providers on or before November, 1, 2021;
    (6) Direct the State Health Plan to provide claim encounter data to support the HIE Authority’s report and fulfill responsibilities to operate the State Health Plan Division by November 1, 2021; and
    (7) Direct the State Health Plan Division to use and disclose claim payment data as needed to satisfy the HIE Authority’s reporting requirement.


  • Summary date: May 18 2021 - More information

    Senate committee substitute to the 2nd edition makes the following changes.

    Revises the proposed changes to and further amends GS 90-414.4. Revises the mandatory health information exchange network (HIE Network) participation dates set forth in subsection (a1) as follows. Adds a new provision to subdivision (3), which requires prepaid health plans and LME/MCOs to submit encounter and claims data by specified dates, authorizing the Department of Health and Human Services to submit the required data on behalf of these entities. Revises the proposed changes to subdivision (4), now requiring participation by physicians who perform procedures at ambulatory surgical centers by January 1, 2023 (previously, the 2nd edition eliminated required participation by ambulatory surgical centers, whose deadline was extended from June 1, 2021, in the 1st edition). Makes conforming changes to subsection (b), previously revised to exclude ambulatory surgical centers from the provisions of the subsection, which condition State funding upon twice daily data submissions regarding services rendered to Medicaid and other State-funded health care program beneficiaries and paid for with Medicaid or other State-funded health care funds. Now explicitly requires a physician who performs a procedure at the ambulatory surgical center to be connected to the HIE Network. Deletes proposed new subsection (b1), which prohibited providers or entities whose receipt of State funds is negatively impacted by a failure to connect to the HIE Network and submit required data from balance billing any services rendered to State-funded health care program beneficiaries, and deemed those beneficiaries not responsible for improper charges.


  • Summary date: May 4 2021 - More information

    House committee substitute to the 1st edition makes the following changes.

    Revises the proposed changes to and further amends GS 90-414.4. Adds a new provision, explicitly charging the Department of Information Technology (DIT), the Department of State Treasurer, State Health Plan Division, and the Department of Health and Human Services (DHHS), Division of Health Benefits (DHB) with the affirmative duty to facilitate and support participation by covered entities in the statewide health information exchange network (HIE network). Revises the mandatory HIE Network participation dates as follows. Requires participation by providers of Medicaid and State-funded health care services, now explicitly including their affiliated entities, not otherwise provided for by January 1, 2023 (was, extended to October 1, 2022, from October 1, 2021). Requires participation by licensed dentists, licensed physicians with a primary practice in psychiatry, and the State Lab of Public Health by January 1, 2023 (was, extended to June 1, 2022, from June 1, 2021). Requires participation by registered pharmacies, and State health care facilities under the Secretary of the Department of Health and Human Services' jurisdiction by January 1, 2023 (was, extended to June 1, 2022, from June 1, 2021). Makes conforming changes to the prohibitions against extensions beyond the new deadline of January 1, 2023, for these specified entities. No longer requires participation by ambulatory surgical centers by June 1, 2021 (was, extended to June 1, 2021; now eliminated with no replacement deadline). Makes conforming changes to exclude ambulatory surgical centers from the provisions of subsection (b), which condition State funding upon twice daily data submissions regarding services rendered to Medicaid and other State-funded health care program beneficiaries and paid for with Medicaid or other State-funded health care funds. Enacts a new subsection to prohibit providers or entities whose receipt of State funds is negatively impacted by a failure to connect to the HIE Network and submit required data from balance billing any services rendered to State-funded health care program beneficiaries, and deems those beneficiaries not responsible for improper charges.

    Amends GS 90-414.6 to prohibit the HIE Authority from fulfilling a request for electronic health information or other medical records from an individual, an individual's personal representative, or an individual or entity purporting to act on an individual's behalf. Instead, requires the Authority to make available to the requester and the public, on its website, educational materials about how to access such information from other sources. 

    Directs the HIE Advisory Board to submit recommendations to the specified NCGA committee by December 1, 2022, regarding appropriate features or actions to support enforcement of the Statewide HIE Act, Article 29B of GS Chapter 90.

    Changes the act's titles. 


  • Summary date: Mar 24 2021 - More information

    Amends GS 90-414.4(a1), making the following one-year extensions for mandatory connection to the Health Information Exchange (HIE) Network. Requires participation by providers of Medicaid and State-funded health care services not otherwise provided for by October 1, 2022. Requires participations by ambulatory surgical centers, licensed dentists, licensed physicians with a primary practice in psychiatry, and the State Lab of Public Health by June 1, 2022. Requires participation by registered pharmacies, and state health care facilities under the Secretary of the Department of Health and Human Services' jurisdiction by June 1, 2022. 


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