The House committee substitute to the 3rd edition is to be summarized.

House committee substitute makes the following changes to the 4th edition.

Amends GS 53B-4(13), concerning access to financial records by government authority, providing that such access can be granted pursuant to a subpoena delivered to the financial institution pursuant to GS 108A-116 by a (1) county department of social services director who is investigating a credible report of financial exploitation of a disabled adult or (2) a law enforcement agency investigating a credible report of financial exploitation of a disabled adult or older adult (previously, provided access to the same parties pursuant to a written, specified notice for access to financial records delivered in accordance with specified procedures for process).

Amends GS 53B-9, making conforming changes.

Amends the definition for customer found in GS 108A-113, providing a customer is a person who is a present or former holder of an account with a financial institution (was, a person who has transacted business with a financial institution or has used the services offered by a financial institution).

Changes the title for proposed subsection GS 108A-114 to Financial institutions encouraged to offer disabled adult and older adult customers the opportunity to submit a list of trusted persons to be contacted in case of financial exploitation (was, Financial institutions encouraged to maintain list of contacts in case of financial exploitation). Adds language providing that financial institutions or its employees will not be held liable when offering its customers the opportunity to submit and update a list of customer contacts when done in good faith.

Amends GS 108A-115, providing that financial institutions or its employees will not be held liable when acting in good faith in making a report regarding suspected fraud under this section.

Amends GS 108A-116, making conforming changes to its title and provisions, requiring financial institutions to provide financial records after receipt of a subpoena from a law enforcement agency or county department of social services investigating alleged exploitation (previously, required disclosure of records after receiving a specified written notice). Establishes requirements for the subpoena, primarily who can issue the subpoena. Sets out the accepted methods of delivery for the subpoena, including by hand, via certified mail with return receipt requested, or a method authorized by 26 USC §7502(f)(2) and to whom it can be delivered, including vice presidents, office managers, or assistant branch or office managers of the financial institution and specified agents for service of process. Requires prompt delivery of financial records after receipt of a subpoena delivered pursuant to specified requirements. Provides protections against liability when acting in good faith under this section.

Amends GS 108A-117, requiring the investigating entity to immediately provide the customer with written notice of its action by first class mail after the issuance of a subpoena pursuant to GS 108A-116, allowing access to financial records (was, required the investigating entity to provide notice within 180 days after obtaining access to the records pursuant to a specified written notice). Makes conforming changes. Provides that an investigating entity can include in its request for a subpoena a request for an order delaying the customer notice requirements. Allows the judge or magistrate issuing the subpoena to order such delayed notice upon a finding, based on affidavits or sworn oral testimony, that certain specified conditions are met. After making such findings, the judge or magistrate must enter an ex parte order granting the requested delay for a period not to exceed 30 days (was, 180 days). If there is reason to believe that the notice could endanger the life or physical safety of any person, the delay order can be ordered for a period not to exceed 180 days (previously, allowed for indefinite delay). Sets out what the order delaying notice must direct, including that the order be sealed until otherwise ordered by the judge or magistrate.  Includes provisions for further extensions of the delay of notice, allowing the judge or magistrate to order an extension upon a finding of the continued existence of the conditions originally provided for by the delay. Provides that extensions cannot exceed the period of time for which the order delaying notice was originally granted for, with extensions for original periods of delay of up to 30 days only being allowed to be renewed and extended up to 90 days total. Delays ordered because of physical safety and endangerment concerns can continue to be renewed and extended until such risks do not exist.

Directs the Consumer Protection Division of the Department of Justice to add the NC Bar Association to the list of approved associations represented on the Task Force on Fraud Against Older Adults.

Changes the effective date for Sections 2, 3, and 4 of the act to December 1, 2013 (was, October 1, 2013).

 

 

House committee substitute to the 2nd edition adds the following provisions.

Amends GS 14-45.1(e) to expand the prohibition against requiring a health care provider who states an objection to abortion on moral, ethical, or religious grounds to participate in medical procedures, which result in an abortion, to also include any other health provider (was, applied to physicians licensed in North Carolina and nurses only). Clarifies that refusal of a physician, nurse, or health care provider is not a basis for damages or for any disciplinary or other recriminatory action against a physician, nurse, or health care provider. Provides that for the purposes of this section, health care provider has the same meaning as defined under GS 90-410(1). Amends GS 14-45.1(f) to clarify that nothing in this section is to require a health care institution, hospital, or other health care provider to perform an abortion or to provide abortion services (was, a hospital or a health care institution). Makes this section effective 30 days after it becomes law.

Enacts new GS 58-51-63, citing authority granted to the states under 42 USC § 18023(a), to prohibit a qualified health plan offered through an Exchange created under Subchapter III of Chapter 157 of Title 42 of the U.S. Code and operating within this state from including coverage for abortion services. Makes an exception for abortions performed when the pregnancy is a result of rape or incest or the mother's life is endangered.

Amends 153A-92(d) to prohibit a county from providing abortion coverage greater than that provided by the State Health Plan for Teachers and State Employees under Article 3B of GS Chapter 135. Amends GS 160A-162(b) to implement the same prohibition with regards to the provision of health insurance by a city council to city employees. Applies to insurance contracts or policies issued, renewed, or amended on or after October 1, 2013.

Enacts new Article 1K, Certain Abortions Prohibited, in GS Chapter 90, effective October 1, 2013, and applying to violations occurring on or after that date. Provides that, notwithstanding GS 14-45.1, no person will perform or attempt to perform an abortion on a woman in North Carolina with knowledge, or an objective reason to know, that a significant factor in seeking the abortion is related to the sex of the unborn child. Establishes that this section will not be construed as creating an affirmative duty for a physician to inquire if the sex of the unborn child is a significant factor in seeking the abortion.

Provides for civil remedies for violations. Makes any person who violates the provisions of this Article liable for damages, including punitive damages under GS Chapter 1D and provides that the violator may be enjoined from future acts.

Allows a claim for damages against any person who has violated a provision of this Article to be sought by (1) the woman upon whom an abortion was performed or attempted, (2) the spouse or guardian of the woman upon whom an abortion was performed or attempted, or (3) a parent of a woman upon whom an abortion was performed or attempted if the woman was a minor at the time of the abortion or the attempted abortion.

Allows a claim for injunctive relief to be sought by (1) the woman upon whom an abortion was performed or attempted in violation of this Article; (2) any person who is the spouse, guardian, or current or former licensed health care provider of the woman upon whom an abortion has been performed or attempted in violation of this Article; or (3) a parent of the woman upon whom the abortion was performed or attempted if the woman was a minor at the time of the abortion or the attempt. Provides for civil contempt and fines for the violation of an injunction. Provides that each performance or attempted performance of an abortion in violation of an injunction is a separate violation and that the fines are cumulative. Prohibits assessing a fine against the woman upon whom the abortion was performed or attempted. Directs that the clear proceeds of any civil penalty assessed under this section are to be remitted to the Civil Penalty and Forfeiture Fund in accordance with GS 115C-457.2.

Requires the court to rule whether the anonymity of any woman upon whom an abortion has been performed or attempted must be preserved from public disclosure if the woman does not give her consent to the disclosure. Upon determining that the woman's anonymity should be preserved, requires the court to issue orders to the parties, witnesses, and counsel and to direct the sealing of the record and exclusion of individuals from courtrooms or hearing rooms to the extent necessary to safeguard the woman's identity from public disclosure. Requires such orders to be accompanied by specific written findings explaining (1) why the anonymity of the woman should be preserved from public disclosure; (2) why the order is essential to that end; (3) how the order is narrowly tailored to serve that interest; and (4) why no reasonable, less restrictive alternative exists. Prohibits construing this section to be used to conceal the identity of the plaintiff or of witnesses from the defendant.

Makes a conforming change to the definition for attempt to perform an abortion provided in GS 90-21.81(2). Effective October 1, 2013.

GS 90-21.82 provides that a woman must provide voluntary and informed consent to receive an abortion. Amends this section to specify the following information that a physician or qualified professional must provide orally (by telephone or in person) to the woman at least 24 hours before an abortion is performed, except in the case of a medical emergency: (1) the name of the doctor who will perform the abortion to ensure the safety of the procedure and prompt medical attention to any complications that may arise; (2) the doctor performing the abortion will be physically present during the performance of the entire abortion procedure; and (3) the doctor prescribing, dispensing or otherwise providing any drug or chemical for the purpose of inducing an abortion will be physically present in the room with the patient when the first drug or chemical is administered to the patient.

Amends GS 90-21.83 to direct the Department of Health and Human Services (DHHS) make a list of resources available on the state web site that a woman may contact for assistance upon receiving information from the physician performing an ultrasound that her unborn child may have a disability or serious abnormality. Directs DHHS to provide the information in a manner as prescribed by subsection (b) of this section.

Directs DHHS to amend its rules for clinics certified by DHHS to be suitable facilities for performing abortions under GS 14-45.1. Allows DHHS to apply any requirement for the licensure of ambulatory surgical centers to the standards that apply to clinics certified as suitable facilities for performing abortions. Specifies issues that must be addressed by the rules. Directs DHHS to report to the Joint Legislative Oversight Committee on Health and Human Services on its progress in amending the rules no later than January 1, 2014. Requires the DHHS, Division of Health Service Regulations, to study what resources are needed to adequately enforce regulations for clinics certified as suitable for performing abortions. Requires a report by April 1, 2014, to the Joint Legislative Oversight Committee on Health and Human Services and the Fiscal Research Division. This section becomes effective October 1, 2013.

Adds a severability clause. Makes conforming changes. Amends the act's short and long titles.

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

Amends proposed GS 120-30.9J as follows. Repeals any ordinance, resolution, act, policy, or law that prior to June 25, 2013 (was, January 1, 2013) the US Department of Justice interposed an objection or the US District Court for the District of Columbia denied a declaratory judgment under Section 5 of the Voting Rights Act of 1965. Provides that the statute does not apply where the US Department of Justice withdrew its objection or after the Department interposed an objection, the US District Court for the District of Columbia issued a declaratory judgment that the ordinance, resolution, act, policy, or law did not violate Section 5.

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

Changes the title of new GS Chapter 108D to Medicaid Managed Care for Behavioral Health Services (was, LME/MCO Enrollee Grievances and Appeals). Makes clarifying changes to the definitions in GS 108D-1, spelling out acronyms and defining a Local Management Entity/Managed Care Organization (LME/MCO) as defined in GS 122C-3(20c). Amends the definition for network provider to delete provision that the term also includes a provider of emergency services. Deletes the definition for provider.

Makes organizational, clarifying, and stylistic changes. Places LME/MCO enrolleegrievances and appeals procedures in new Article 2, Enrollee Grievances and Appeals. Clarifies that there is no right to appeal the resolution of an LME/MCO grievance tothe Office of Administrative Hearings (OAH) or any other forum.

Amends new GS 108D-6 to delete specifications regardingthe content ofawritten notice of a managed care action to an enrollee and of the enrollee's right to appeal the managed care action, insteadrequiring that an LME/MCO provide an enrollee with written notice of a managed care action via United States mail as required under 42 CFR Part 438, Subpart F.

Provides that an enrolleeor a network provider with written authorization to act on behalf of an enrolleehas a right to file a request for an LME/MCO level appeal of a notice of managed care action no later than 30 days after the mailing date of the notice of managed care action or the grievance disposition.

Makes a technical correction to new GS 108D-6 and GS 108D-7 to provide that the enrollee is to be provided with an appeal request form for a contested case hearing that meets the requirements of GS 108D-8(f).

Amends GS 108D-7, adding a new subsection (f) to require an LME/MCO to provide an enrollee with reasonable assistance in completing forms and taking other procedural steps necessary to file an appeal including providing (1) interpreter servicesand (2) toll free numbers with adequate teletypewriter/telecommunications devices for the deaf and interpreter capability. Re-letters subsections as necessary.

Amends GS 108D-8 to provide that in requesting an appeal, the enrollee must file the appeal request form in accordance with OAH rules. Provides that any simplified hearing procedures approved by the chief administrative law judge (ALJ) must comply with all of the specified requirements in GS 108D-8(h). Directs the ALJ assigned to hear the case to consider and rule on all pre-hearing motions before the scheduled date for a hearing on the merits of the case (was, may includesuch a requirement). Provides that the enrollee has the burden of proof on all issues submitted to the OAH for a contested hearing under this section and the enrollee has the burden of going forward (was, provided the enrollee has burden of proof to show entitlement to a requested benefit under specified circumstances and the agency has the burden of proof in an appeal from a managed care action to impose a penaltyor to reduce, terminate, or suspend a previously granted benefit).

Deletes amendment to GS 122C-3, which defined LME/MCO as an LME approved by the Department of Health and Human Services (DHHS) to operate the 1915(b)/(c) Medicaid Waiver.

Amends GS 122C-151.3 and GS 122C-151.4 to clarify that these sections do not apply to specified LME/MCOs, enrollees, applicants, emergency service providers, or network providers subject to GS Chapter 108D. Amends GS 150B-23 to provide that an LME/MCO is considered an agency as defined in GS 150B-2(1a) only for the purposes of contested cases commenced as Medicaid managed care enrollee appeals under GS Chapter 108D.

Directs DHHS to take any action necessary to implement this act by September 30, 2013, including submitting to the Centers for Medicare and Medicaid Services a Medicaid State Plan Amendment with a retroactive effective date of July 1, 2013 (was, required DHHS to submit a plan to implement this act on or before December 1, 2013).DHHS is to report to the Joint Legislative Oversight Committee on Health and Human Services on the status of the implementation of this act on or before September 30, 2013.

Makes this act effective when it becomes law (was, effective June 1, 2014) and applies to grievances and managed care actions filed on or after that date.