HEALTH COST TRANSP/SPEAKER AND PPT STANDING (NEW).

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View NCGA Bill Details2013-2014 Session
Senate Bill 473 (Public) Filed Wednesday, March 27, 2013
A BILL TO BE ENTITLED AN ACT TO AMEND THE PROVISIONS OF HOUSE BILL 834 RELATED TO HEALTH CARE COST REDUCTION AND TRANSPARENCY AND FAIR HEALTH CARE BILLING AND COLLECTIONS PRACTICES; AND TO ALLOW THE SPEAKER OF THE HOUSE AND PRESIDENT PRO TEMPORE OF THE SENATE, AS AGENTS OF THE STATE, TO JOINTLY INTERVENE ON BEHALF OF THE GENERAL ASSEMBLY IN ANY JUDICIAL PROCEEDING CHALLENGING A NORTH CAROLINA STATUTE OR A PROVISION OF THE NORTH CAROLINA CONSTITUTION.
Intro. by Rucho, Brown.

Status: Ch. SL 2013-393 (Senate Action) (Aug 23 2013)

SOG comments (3):

Long title change.

Committee substitute changes the long title. The original long title is as follows:

A BILL TO BE ENTITLED AN ACT TO IMPROVE TRANSPARENCY IN THE COST OF HEALTH CARE PROVIDED BY HOSPITALS AND AMBULATORY SURGICAL FACILITIES; TO TERMINATE SET-OFF DEBT COLLECTION BY CERTAIN STATE AGENCIES PROVIDING HEALTH CARE TO THE PUBLIC; TO PROHIBIT HOSPITALS AND AMBULATORY SURGICAL FACILITIES FROM CHARGING MULTIPLE TIMES FOR OUTPATIENT RADIOLOGY SERVICES RENDERED ONLY ONCE; TO PROVIDE FOR FAIR HEALTH CARE FACILITY BILLING AND COLLECTIONS PRACTICES; AND TO ENCOURAGE COMMUNITY CARE OF NORTH CAROLINA TO ADJUST ITS CORPORATE GOVERNANCE.

Long Title

House committee substitute to the 3rd edition makes changes to the long title. The original title was:

AN ACT TO IMPROVE TRANSPARENCY IN THE COST OF HEALTH CARE PROVIDED BY HOSPITALS AND AMBULATORY SURGICAL FACILITIES; TO TERMINATE SET-OFF DEBT COLLECTION BY CERTAIN STATE AGENCIES PROVIDING HEALTH CARE TO THE PUBLIC; TO MAKE IT UNLAWFUL FOR HEALTH CARE PROVIDERS TO CHARGE FOR PROCEDURES OR COMPONENTS OF PROCEDURES THAT WERE NOT PROVIDED OR SUPPLIED; TO PROVIDE FOR FAIR HEALTH CARE FACILITY BILLING AND COLLECTIONS PRACTICES; AND TO PROVIDE GUIDANCE ON THE GOVERNANCE OF ENTITIES TO MANAGE CARE AND CONTROL COSTS STATEWIDE.

Long title change

House committee substitute to the 4th edition changed the long title. Previous long title was A BILL TO BE ENTITLED AN ACT to improve transparency in THE COST OF HEALTH CARE PROVIDED BY HOSPITALS and ambulatory surgical facilities; to terminate set‑off debt collection by certain state agencies providing HEALTH care to the public; to make it unlawful for health care providers to charge for procedures or components of procedures that were not provided or supplied; tO PROVIDE FOR FAIR HEALTH CARE FACILITY BILLING and collections PRACTICES; and to provide that hospitals receiving medicaid reimbursements participate in the north carolina health information exchange network.

Bill History:

S 473/S.L. 2013-393

Bill Summaries:

  • Summary date: Sep 3 2013 - View Summary

    AN ACT TO AMEND THE PROVISIONS OF HOUSE BILL 834 RELATED TO HEALTH CARE COST REDUCTION AND TRANSPARENCY AND FAIR HEALTH CARE BILLING AND COLLECTIONS PRACTICES; AND TO ALLOW THE SPEAKER OF THE HOUSE AND PRESIDENT PRO TEMPORE OF THE SENATE, AS AGENTS OF THE STATE, TO JOINTLY INTERVENE ON BEHALF OF THE GENERAL ASSEMBLY IN ANY JUDICIAL PROCEEDING CHALLENGING A NORTH CAROLINA STATUTE OR A PROVISION OF THE NORTH CAROLINA CONSTITUTION. Enacted August 23, 2013. Section 1 is effective December 1, 2013. Section 2 is effective October 1, 2013. The remainder is effective August 23, 2013.


  • Summary date: Jul 26 2013 - View Summary

    House amendment to the 5th edition makes the following changes. Adds to GS 1-72.2 (Standing of legislative officers) that the procedure in state court will be that set fourth in Rule 24 of the Rules of Civil Procedure.


  • Summary date: Jul 25 2013 - View Summary

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

    Deletes all the provisions of the 4th edition.

    Provides that if House Bill 834, 2013 Regular Session becomes law, then this act amends GS 131E-273 as enacted by House Bill 834 to provide that where informed consent is required for a procedure, the charge for any part of the procedure performed prior to the patient giving consent cannot exceed the actual cost to the provider if the patient chooses not to consent. Effective December 1, 2013, and applies to health care procedures and services rendered on or after that date.

    Provides that if House Bill 834, 2013 Regular Session becomes law,then this act alsoamends GS 131E-91(d)(5), as enacted by House Bill 834, to prohibit a lien arising out of a debt owed to a hospital or ambulatory surgical facility, when the land where the principal residence is located is greater than five acres, from attaching to the judgment debtor's principal residence and the surrounding five acres. Effective October 1, 2013, and applies to hospital and ambulatory surgical facility billings and collections practices occurring on or after that date.

    Enacts a new GS 1-72.2 to provide that the Speaker of the House of Representatives and the President Pro Tempore of the Senate jointly have standing to intervene on behalf of the General Assembly as a party in any judicial proceeding challenging a North Carolina statute or provision of the North Carolina Constitution.

    Rewrites the long and short titles of the bill to reflect the changes in bill content.


  • Summary date: Jul 24 2013 - View Summary

    House committee substitute makes the following changes to the 3rd edition.

    Amends the long title.

    Amends proposed GS 131E-214.6(b), which requires each hospital, beginning with the quarter ending March 31, 2014, to provide DHHS with specified pieces of information about the 100 most frequently reported admissions by DRG for inpatients, clarifying that they must provide information on the five largest health insurers providing payment to the hospital on behalf of teachers and State employees in addition to insureds (previously, only provided for information  to be submitted on insureds). Adds new language providing that a hospital is not required to report the information required by GS 131E-214.6(b) when the reporting of such information could reasonably lead to the identification of the people that were admitted to the hospital in violation of HIPAA regulations. Changes the date by which the NC Medical Care Commission (Commission) must adopt rules to ensure implementation of this requirement to March 1, 2014 (was, January 1, 2014).

    Requires each hospital and ambulatory surgical facility to provide DHHS information on the total costs for the 20 most common surgical procedures and the 20 most common imaging procedures along with related codes beginning with the quarter ending September 30, 2014 (was, June 30, 2014). Provides that information that would lead to the identification of people admitted to the hospital, in violation of HIPAA regulations is not required to be submitted. Requires the Commission to adopt rules to ensure implementation of this requirement by June 1, 2014 (was, March 31, 2014).

    Directs the State Health Plan (SHP) for Teachers and State Employees to establish a workgroup to examine the best way to provide teachers and State employees with greater transparency in regards to health services costs under the SHP. Requires the SHP to report the workgroup's findings and recommendations to the Joint Legislative Oversight Committee on Health and Human Services and the Joint Committee on Governmental Operations on or before December 31, 2013, and annually through December 31, 2016.

    Directs the Department of Health and Human Services (DHHS) to communicate, not later than September 1, 2013 (was, July 1, 2013), the requirements of Section 2 of the act to all hospitals licensed pursuant to Article 5 of GS 131E and Article 2 of GS 122C, as well as to all ambulatory surgical facilities licensed pursuant to Part 4 of Article 6 of GS 131E.

    Amends GS 131E-273 by adding that if a procedure requires a patient's informed consent, the charge for any component of the procedure performed before the consent is given does not exceed the actual cost to the provider if the patient decides not to consent.

    Amends GS 131E-91(d)(5), by amending a collection practice that must be used by hospitals and ambulatory surgical facilities to provide that no lien arising out of a judgment for a debt owed a hospital or ambulatory surgical facility under this section must attach to judgment debtors principal resident, or, if the land upon which the residence is located is greater than five acres, then no lien attaches to the residence and the surrounding five acres, held by them as tenants by the entireties.

    Enacts new GS 90-413.3A, Required participation in NC HIE for some providers, requiring any hospital, as defined in GS 131E-76(c) and that has an electronic health record system, to connect to the NC HIE and submit individual patient demographic and clinical data on services paid for with Medicaid funds. Also includes three specific findings by the General Assembly which provides the basis for requiring the connection to the NC HIE. Effective January 1, 2014, but will not apply to administrative actions or litigation filed before the effective date.

    Provides that new GS 131E-273 does not apply to administrative actions or litigation filed before the December 1, 2013 effective date.


  • Summary date: May 8 2013 - View Summary

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

    Changes the long title.

    Deletes proposed changes to GS 90-413.2, Purpose, and GS 90-413.9, Disclosure of prices for most common episodes of care.

    Enacts new Article 1B, Transparency in Health Care Costs, in GS Chapter 131E. Provides that the intent of the Article is to improve transparency in health care costs by providing information to the public on the costs of the most frequently reported diagnostic related groups (DRG) for hospital inpatient care and the most common surgical procedures and imaging procedures in hospital outpatient settings and ambulatory surgical facilities. Requires the Department of Health and Human Services (DHHS) to make available on its website the most current price information it receives from hospitals and ambulatory surgical facilities; sets out minimum requirements for that information. Requires each hospital, beginning with the quarter ending March 31, 2014, to provide DHHS six specified pieces of information about the 100 most frequently reported admissions by DRG for inpatients, including the total amount of Medicare reimbursements, and the total amount of payments made by the State Health Plan for Teachers and State Employees. Requires the NC Medical Care Commission (Commission) to adopt rules to ensure implementation of this requirement by January 1, 2014, and specifies information to be included in the rules. Requires each hospital and ambulatory surgical facility to provide DHHS information on the total costs for the 20 most common surgical procedures and the 20 most common imaging procedures along with related codes. Requires the Commission to adopt rules to ensure implementation of this requirement by March 31, 2014, and specifies information to be included in the rules. The information required may be provided to a patient upon request. Requires a hospital or ambulatory surgical facility required to file a Schedule H, federal form 990, to provide the public with access to its financial assistance policy and its annual financial assistance costs. Requires the information to be reported to DHHS annually and to be reported on the DHHS website and at the organization's place of business.

    Directs the Department of Health and Human Services (DHHS) to communicate, not later than July 1, 2013, the requirements of Section 2 of the act to all hospitals licensed pursuant to Article 5 of GS 131E and Article 2 of GS 122C, as well as to all ambulatory surgical facilities licensed pursuant to Part 4 of Article 6 of GS 131E.

    Amends GS 131E-97.3, providing that competitive health care information does not include the information that hospitals and ambulatory surgical facilities are required to report under GS 131E-214.6.

    Amends GS 131E-99, excluding information a hospital or an ambulatory surgical facility is required to report under GS 131E-214.6 from the confidentiality requirements for health care contracts.

    Enacts new GS 131E-273, Certain charges/payments prohibited, providing that it is unlawful for any provider of health care services to charge or accept payment for a health care procedure that was not actually performed or supplied.

    Deletes Section 9 of the previous edition,  which proposed a new section, GS 131E-91.3, Duplicate charges for certain radiology services prohibited.

    Amends GS 131E-91, Fair billing and collections practices for hospitals and ambulatory surgical facilities, making organizational changes. Provides that a hospital or ambulatory surgical facility has 45 (was, 60) days from the time notice of overpayment is received to refund an overpayment resulting from specified circumstances. Amends GS 131E-91(d)(5), providing that for debts arising from the provision of care by a hospital or ambulatory surgical facility, the doctrine of necessaries as it existed at common law will apply equally to both spouses, with specified exceptions. Provides further rules or regulations regarding debt owed to a hospital or ambulatory surgical facility. Also provides that hospitals or ambulatory surgical facilities that provide care to a minor cannot execute or force the sale of the principal residence of the custodial parent for a judgment obtained for the outstanding debt until the minor is either no longer residing with the parent or until the minor reaches the age of majority, whichever occurs first.

    Repeals Article 2A of GS 131E, Garnishment for Debts Owed Public Hospitals.

    Amends Part VI of the act, renaming it Governance of Entities to Manage Care and Control Costs Statewide, establishing that the governance of entities contracting with the state to provide centralized care coordination, cost containment, or management of care on a statewide basis for the Medicaid program is of significant importance. Further finds that the public has a profound interest in ensuring the quality of internal governance in regards to this contracting.  As such, DHHS will not enter into a new contract with an entity to provide cost containment or management of care on a statewide basis for the Medicaid program unless the entity adheres to certain specified governance provisions.

    Amends the enactment clause, providing that Sections 4 and 5 of this act become effective January 1, 2014. Section 6 of this act becomes effective December 1, 2013, and applies to health care procedures and services rendered on or after that date. Section 7 of this act becomes effective January 1, 2014, and applies to tax refunds determined by the Department of Revenue on or after that date. Section 8 of this act becomes effective October 1, 2013, and applies to hospital and ambulatory surgical facility billings and collections practices occurring on or after that date. The remainder of this act is effective when it becomes law.

     


  • Summary date: Apr 25 2013 - View Summary

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

    Amends proposed GS 90-413.9 to specify that the information published by NC Health Information Exchange (HIE) on its Internet web sitebe publishedin a conspicuous manner, and that the information be the most current information available. Adds new subsection (b), which declares that any data disclosed by a hospital or ambulatory surgical facility to the NC HIE under the Health Care Cost Reduction and Transparency Act of 2013 (Act) remains the sole property of the facilitysubmitting the data. Provides that any data or product derived from the data that was disclosed to NC HIE pursuant to the Actof 2013, including a consolidation or analysis of the data, remains the sole property of the state of North Carolina. Prohibits the NorthCarolina Community Care Networks., (CCNC), NC HIE, and all other entities thatreceive datadisclosed by a hospital or ambulatory surgical facility under the Act from disclosing, selling, or exchanging the data, or from engaging in any consolidation, analysis, or product derived from the data, for a fee or consideration of any type.

    Amends new GS 131E-91.1 to clarify that the term "episode of care" includes services by health care providers employed by the hospital (was, affiliated with the hospital). Amends the definition for "health insurer" to provide that the term does not include self-insured plans and group heath plans as defined in section 607(1) of the Employee Retirement Income Security Act of 1974. Requires each hospital licensed under Article 5 of GS Chapter 131E to electronicallyprovide to NC HIE, beginning onMarch 31, 2014 and quarterly thereafter, (was, annually beginning on January 1, 2014), specific information regarding costs, payments, and reimbursementsfor the hospital's 50 most common episodes of care. Adds to the list of specified information required that the list must include the average negotiated settlement on the amount that will be charged to a patient andthat must be remitted in subdivision (1) of this subsection. Also clarifies that the total amount of Medicaid reimbursements for each episode of care includes claims and pro rata supplemental payments. Changes the required content of the rules adopted by the NC Medical Care Commission (Commission) to implement this section, providing that the rules must include (1) the 50 most common episodes of care on which the hospitals must report, and (2) specific categories by which hospitals are to be grouped for the purpose of disclosing this information to the public on the NC HIE Internet web site.

    Amends GS 131E-91.2 to require that a hospital's posting of its policy on charity care, also include the amounts spent by the hospital on uncompensated care and bad debt in the preceding calendar year. Adds definitions for "bad debt" and "uncompensated care." Amends GS 131E-153.1(was, 131E-153.2) to providesubstantively similar provisions as they apply to ambulatory surgical facilities.

    Amends GS 131E-153 (was, 131E-153.1) applying to the disclosure of prices for ambulatory surgical services. Modifies the definition for "episode of care" to include pharmaceuticals dispensed by the ambulatory surgical facility pharmacy or by a pharmacy owned or controlled by the ambulatory surgical facility. Requires that the rules adopted by the Commission include the 50 most common episodes of care on which the ambulatory surgical facilities must report.

    Enacts new GS 131E-91.3 as new Part 4B of Article 5 of GS Chapter 131E (was, added as new section to Part 4A of GS Chapter 131E, Article 5). Adds a definition for "provider of radiology services." Defines provider of radiological services as a hospital, ambulatory surgical facility, a freestanding radiology services facility, or a physician's office that provides outpatient radiology services.Amends criteria for unlawful duplicate charges for outpatient imaging radiology services and extends the provisions to include providers of radiology services. Makes a conforming deletion ofnew GS 131E-153.3 having to do with prohibiting duplicate charges for certain radiology services from an ambulatory surgical facility or health care providers affiliated with the facility.

    Deletes changes to GS 108A-121, definitions in Article 7, Hospital Provider Assessment Act,of GS Chapter 108A.

    Amends GS 131E-91 to apply to fair billing and collections practices for hospitals and ambulatory surgical facilities. Includes provisions that require bills to be legible, easily understandable, and to included clear explanations when the use of medical codes and terms is unavoidable. Also identifies reasonable collection practices which hospitals and ambulatory surgical facilities must use. Prohibits the use of wage garnishment, a lien on a patient's primary residence, or a forced sale as a means of collecting an unpaid bill.

    Enacts new GS 131E-147.1 (Fair billing and collections practices for ambulatory surgical facilities) providing that all ambulatory surgical facilities licensed under Part 4 of Article 6 of GS Chapter131E will be subject to the fair billing and collections practices as set out in GS 131E-91.

    Amends GS 58-3-245, changing section name to Provider directories; cost tools for insured (was, Provider directories) and requires that health benefit plans that utilize a provider network must ensure that a patient is provided accurate and current information about each provider's network status through both the telephone system and any electronic or online system.Adds new GS 58-3-245(d), establishing that health care providers must provide patients or prospective patients, upon request, with information regarding that provider's network status with a particular health benefit plan.

    Delineates governance changes for the North Carolina Community Care Networks, Inc. (CNCC), including changes in the composition of its board.Adds that those changes include ensuring that no member or immediate family member is a registered lobbyist or employed by an entity lobbying for a health care provider association.


  • Summary date: Mar 27 2013 - View Summary

    Names this act the Health Care Cost Reduction and Transparency Act of 2013.

    Amends GS 90-413.2, which states the purpose of Article 29A of GS Chapter 90, to add that this Article is intended to improve transparency in health care costs by providing information to the publicon the cost of the 50 most common episodes of care in (1) hospitals subject to the NC Hospital Licensure Act and (2) ambulatory surgical facilities subject to the NC Ambulatory Surgical Facility Licensure Act.

    Enacts new GS 90-413.9 to direct the NC Health Information Exchange (NC HIE) to establish and maintain an Internet web site containing the most current information it receives from hospitals and ambulatory surgical facilities under new GS 131E-91.1 (Disclosure of prices for most common episodes of care) and new GS 131E-153 (Disclosure of charity care information), as enacted by this act. Instructs the NC HIE to present this information in a format that is easily understood by the public. Specifies minimum requirements that the provided information must meet.

    Enacts new GS 131E-91.1 to require each hospital licensed under Article 5 of GS Chapter 131E to provide to NC HIE, annually beginning on January 1, 2014, andusing electronic health records software, specific information regarding costs, payments, and reimbursementsfor the hospital's 50 most common episodes of care. Requires a hospital to provide this information in writingto any patient requesting itwithin 24 hours after receiving the request. Provides definitions for (1) episode of care, (2) health insurer, and (3) public or private third party. States that the disclosure requirements of this section are not to be construed as requiring a hospital licensed under Article 5 of GS Chapter 131E to participate in the voluntary statewide health information exchange network administered by NC HIE. Directs the NC Medical Care Commission (Commission) to adopt rules to ensure the proper implementation of this section on January 1, 2014, and to insure that hospitals report the information toNC HIE in a uniform manner. Requires that the rules include (1) specific categories for grouping hospitals to disclose this information on the NC HIE Internet web site and (2) methods to insure that hospitals report the most common episodes of care from a cross-section of medical and surgical specialty areas identified by the Commission. Enacts new GS 131E-153.1 to providesubstantively similar provisions as they apply to ambulatory surgical facilities, except defines episode of care to reflect services rendered by an ambulatory surgical facility.

    Enacts GS 131E-91.2 to define charity care to mean the costs of a hospital of providing health care or other services to an uninsured patient or a patient who is otherwise unable to pay for all of the services provided. Directs each hospital operator, beginning January 1, 2014, and annually thereafter, to post conspicuously the hospital policyon charity care from the preceding calendar year (1) on the licensed premises in an area accessible to the public and (2) on the hospital's Internet web site where it is made available to the public. Enacts new GS 131E-153.2 to providesubstantively similar provisions as they apply to ambulatory surgical facilities.

    Recodifies GS 131E-91 in Part 4A of Article 5 of GS Chapter 131E (was, codified in Part 4 of Article 5 of GS Chapter 131E). Amends GS 131E-91 to require that all hospitals (was, all hospitals and ambulatory surgical facilities) licensed under Article 5 (was, under Chapter 131E) provide a dischargedpatient upon request with an itemized list of all charges to the patient. Makes conforming changes and stylistic changes. Enacts new GS 131E-153 in Part 4 of Article 6 of GS Chapter 131E to apply the same provisions regarding providing a discharged patient with itemized charges upon request for all ambulatory surgical facilities licensed in this Part.

    Directs the Department of Health and Human Services to communicate the requirements in this act pertinent to hospitals to all hospitals licensed under Article 5 of GS Chapter 131E and the requirements in this act pertinent to ambulatory surgical facilities to all ambulatory surgical facilities licensed under Part 4 of Article 6 of GS Chapter 131E no later than July 1, 2013.

    Amends GS 131E-97.3 to declare that competitive health care information does not include the information that hospitals are required to report under new GS 131E-91.1 or the information that ambulatory surgical facilities are required to report under new GS 131E-153. Amends GS 131E-99 to exclude the information required in new GS 131E-91.1 and new GS 131E-153 from the confidentialityrequirements forhealth care contracts. Effective January 1, 2014.

    Enacts new GS 131E-91.3 (applies to hospitals licensed under Article 5)to prohibit and make unlawfulduplicate charges for certain radiology services. Includes definitions for the following terms as they apply in this section: (1) clinical labor, (2) multiple radiology session, and (3) technical components. Enacts new GS 131E-153.3 (applies toambulatory surgical facilitieslicensed under Part 4 of Article 6)to prohibit and make unlawfulduplicate charges for certain radiology services. Includes definitions for the following terms as they apply in this section: (1) clinical labor, (2) multiple radiology session, and (3) technical components. Effective July 1, 2013, and applies to outpatient radiology services provided, and contracts executed or renewed, on or after that date.

    Amends GS 105A-2(9) (regarding debt set off collection)to exclude the following from the definition of a state agency: (1) any school of medicine, clinical program, facility, or practice affiliated with one of the constituent institutions of the University of North Carolina that provides medical care to the public and (2) the University of North Carolina Health Care System and other persons or entities affiliated with or under the control of the University Health Care System. Effective January 1, 2014, and applies to tax refunds determined by the Department of Revenue on or after that date.

    Amends the definitions in GS 108A-121 (regarding the Hospital Provider Assessment Act) to make conforming and clarifying changes. Amends GS 108A-122, adding a new subsection (e) to provide that the assessment imposed on all licensed North Carolina hospitals becomesa liability on the part of the hospital for a debt owed to the state from the time the assessment isdue and payable. Requires the Secretary of DHHS to report overdue assessments to the Secretary of the Department of Revenue, who is to collect the debt using the collection remedies under Article 9 of GS Chapter 105. Makes additional modifications to GS 108A-123 regarding the equity assessment amount and the Upper Pay Limit (UPL, the maximum ceiling imposed by the federal regulation on Medicaid payments under 42 CFR �_ 447.272 for inpatient services). Replaces the term "State's Annual Medicaid Payments" with the term "Additional Amount" and prescribes that amount to be the sum of $43 million allocated between the equity assessment and the UPL assessment based in the gross amount of payments received by hospitals under GS 108A-124. Provides for an assessment limit declaring that the Secretary of Revenue is to reduce,if necessary, a hospital's assessment so that it does not exceed the percentage of gross revenue that would result in imposing an impermissible health care-related tax, as defined under federal Medicaid law. Effective July 1, 2013.

    EnactsGS 108A-124(a)(1) and (a)(2)regarding the use of the assessment proceeds. Requires that the assessment proceeds and all corresponding matching federal funds must be used to make the annual payments to the state and the hospitals: (1) payment of $50 million transferred to the State Controller and (2) allocation, by the Secretary of Revenue, of the remaining proceeds to the the hospital providers with low average monthly total Medicaid costs. Retains quarterly payments as imposed under GS 108A-123, but simplifies the payment process to conform with the changes to subsections (a)(1) and (a)(2). Effective July 1, 2013.

    Directs DHHS to file a state plan amendment incorporating the assessment payments and distributions consistent with the amendments made in this actto the provisions of Article 7 of GS Chapter 108A with the Centers for Medicare and Medicaid Services. Requires the Secretary of DHHS to work in conjunction with the Office of Budget and Management and the NC Community Care Networks Inc. to develop the payment methodology under GS 108A-124(a)(2), asenacted in this act. Requires the Secretary of DHHS to consult with the Joint Legislative Commission on Governmental Operations no later than October 1, 2013, prior to making any payments under GS 108A-124(a)(2), as enacted in this act.

    Encourages North CarolinaCommunity Care Networks Inc. (CCNC)to adjust its corporate governance by making changes to amend its articles of incorporation, its bylaws, or taking other appropriate action as indicated in this act. Prohibits DHHS from entering into a contract with CCNC unless CCNC makes the governance changes provided in this act.

    Except as otherwise indicated, effective when this act becomes law.