Bill Summary for S 397 (2017-2018)
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Summary date:
Mar 27 2017
Bill Information:
View NCGA Bill Details | 2017-2018 Session |
AN ACT TO CLARIFY THAT UTILIZATION REVIEW DOES NOT INCLUDE STATISTICAL REVIEW OF A HEALTH CARE PROVIDER'S OR FACILITY'S PRACTICE PATTERNS THAT IS NOT USED TO ADJUDICATE CLAIMS OR APPROVE OR DENY THE PROVISION OF, OR PAYMENT FOR, SERVICES TO AN INSURED INDIVIDUAL.Intro. by Tarte, Hise, Pate.
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Bill summary
Amends GS 58-50-61 to revise the definitions ofutilization review andutilization review organization to exclude statistical review of a health care provider's or facility's practice patterns that are not used to adjudicate claims or approve or deny the provision of, or payment for, services to an insured person.