CLARIFY REASONABLE HEALTH INSUR/LTC OMBUDSMAN.

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View NCGA Bill Details2015-2016 Session
House Bill 308 (Public) Filed Wednesday, March 18, 2015
AN ACT TO AMEND THE LAWS PERTAINING TO THE MEDICAL SUPPORT AND HEALTH INSURANCE COVERAGE RELATING TO CHILD SUPPORT TO ALIGN STATE LAW WITH FEDERAL GUIDELINES THAT NO LONGER INCLUDE THE PROVISION THAT EMPLOYER-PROVIDED GROUP HEALTH INSURANCE IS AUTOMATICALLY CONSIDERED "REASONABLE" AND TO MODIFY THE LONG-TERM CARE OMBUDSMAN PROGRAM TO CONFORM WITH FEDERAL GUIDELINES.
Intro. by Stevens, Glazier, Davis.

Status: Ch. SL 2015-220 (House Action) (Aug 18 2015)

SOG comments (1):

Short and Long Title Changes

Senate committee substitute to the 1st edition made changes to the short and long titles. The original titles were as follows:

CLARIFY REASONABLE HEALTH INSUR/CHILD SUPP.

AN ACT TO AMEND THE LAWS PERTAINING TO THE MEDICAL SUPPORT AND HEALTH INSURANCE COVERAGE RELATING TO CHILD SUPPORT TO ALIGN STATE LAW WITH FEDERAL GUIDELINES THAT NO LONGER INCLUDE THE PROVISION THAT EMPLOYER-PROVIDED GROUP HEALTH INSURANCE IS AUTOMATICALLY CONSIDERED "REASONABLE."

Bill History:

H 308/S.L. 2015-220

Bill Summaries:

  • Summary date: Aug 24 2015 - View Summary

    AN ACT TO AMEND THE LAWS PERTAINING TO THE MEDICAL SUPPORT AND HEALTH INSURANCE COVERAGE RELATING TO CHILD SUPPORT TO ALIGN STATE LAW WITH FEDERAL GUIDELINES THAT NO LONGER INCLUDE THE PROVISION THAT EMPLOYER-PROVIDED GROUP HEALTH INSURANCE IS AUTOMATICALLY CONSIDERED "REASONABLE" AND TO MODIFY THE LONG-TERM CARE OMBUDSMAN PROGRAM TO CONFORM WITH FEDERAL GUIDELINES. Enacted August 18, 2015. Section 2 is effective July 1, 2016. The remainder is effective August 18, 2015.


  • Summary date: Aug 3 2015 - View Summary

    Senate amendment makes the following changes to the 2nd edition.

    Amends the definition of programmatic supervision in GS 143B-181.16 to clarify that it includes ensuring that the Area Agency on Aging has personnel policies and procedures consistent with the laws and policies governing the Ombudsman Program. 

    Amends the State Ombudsman's duties in GS 143B-181.18 to include determining the use of the fiscal resources as required by 42 USC 3001 et. seq. and regulations promulgated thereunder (was, determine the use of fiscal resources appropriated or otherwise available for the operation of the Office, including specified actions).

    Amends GS 143B-181.19 to require the Area Agencies on Aging to provide only personnel management for Regional Ombudsman in accordance with personnel policies and procedures of the Agency that are consistent with federal and state Ombudsman law and policy (was, provide administrative supervision to each Regional Ombudsman limited to the Agency's personnel policies pertaining to time and attendance, benefits, assigned work space and equipment, and general operations of the agency).

    Amends GS 143B-181.23 to require the Department of Health and Human Services (was, the State Ombudsman) to determine the instances of discrimination or retaliation against residents, relatives of residents, or employees of long-term care facilities for making a complaint, and assess the resulting monetary penalty.


  • Summary date: Jul 21 2015 - View Summary

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

    Amends the act's short and long titles. 

    Amends GS 50-13.11(a1) concerning orders and agreements regarding medical support and health insurance coverage for minor children, establishing that health insurance for the benefit of a child is considered reasonable in cost if the coverage is available at a cost to the parent that does not exceed 5% of the parent's gross income (previously, was considered reasonable in cost if it is employment-related or some other type of group health insurance and the coverage of the child is available to the parent at a cost that does not exceed 7% of the parent's gross income). Sets out how the actual cost of the coverage for the child should be calculated for purposes of the section.

    Makes various changes to the Long-term Care Ombudsman Program found in GS Chapter 143B, Part 14D, adding and defining the following new terms for use in this part (1) programmatic supervision, (2) regional ombudsman, and (3) willful interference. Amends the definition of the term State Ombudsman. Adds four additional duties for the State Ombudsman, including designating certified regional ombudsmen as representatives of the State Ombudsman Office and providing leadership for statewide systems advocacy efforts of the Office of the State Ombudsman. Provides that the State Ombudsman has specified administrative supervision over Area Agencies and also is required to ensure that Area Agencies do not have personnel policies or practices that conflict with the laws and policies of the Ombudsman Program. Amends the duties of regional ombudsmen to require them to conduct systems advocacy activities on behalf of long-term care residents when authorized. Clarifies that the State and Regional Ombudsmen can enter long-term care facilities at any time during regular visiting hours or at any other time necessary for the purposes of investigating certain circumstances. Also allows them to have access to any resident as part of the investigation (previously, only reasonable access to residents was required). Provides that the Regional Ombudsman must notify the Adult Protection Services, with the written informed consent of the resident or authorization of the State Ombudsman, when allegations involve suspected abuse, neglect, or exploitation (previously, the State Ombudsman was required to do the same but there was no requirement that written informed consent of the resident was required). Provides for the State Ombudsman to assess monetary penalties in the amount of $2,500 per incident concerning instances of discrimination or retaliation against a resident due to good faith complaints submitted to the State or Regional Ombudsman. Makes conforming, clarifying, and technical changes. Effective July 1, 2016.  


  • Summary date: Mar 19 2015 - View Summary

    Amends GS 50-13.11(a1) concerning orders and agreements regarding medical support and health insurance coverage for minor children, making a clarifying change and adding language establishing that health insurance for the benefit of a child is considered reasonably if, in addition to being employment related or some other type of group health insurance, coverage of the child is available to the parent at a cost that does not exceed 7% of the parent's gross income (previously, only provided that such insurance was considered reasonable if it was employment related or other group health insurance).

    Effective when the bill becomes law, applying to orders issued or agreements entered into on or after that date. 


  • Summary date: Mar 18 2015 - View Summary

    To be summarized.