AN ACT TO MODIFY THE LAWS PERTAINING TO MEDICAID AND NC HEALTH CHOICE AS NEEDED FOR THE IMPLEMENTATION OF MEDICAID TRANSFORMATION.
House committee substitute to the 1st edition makes the following changes.
Modifies the definitions provisions set forth in Article 1, GS Chapter 108D, to remove the qualification which provides that context can preempt the definitions provided. Makes organizational changes to the definitions.
Makes similar changes to the definitions provisions of Part 6A, Article 2, of GS Chapter 108A to remove the qualification which provides that context can preempt the definitions provided. Makes organizational changes to the definitions.
Adds LME/MCO and prepaid health plan to the defined terms set forth in GS 108C-2 that are applicable to GS Chapter 108C. Amends GS 108C-5 to require prepaid health plans or LME/MCOs to suspend payments to a provider and remit the payments to the Department of Health and Human Services (DHHS) upon written notice of DHHS. Requires the prepaid health plan or LME/MCO to notify the provider of the suspension and include a copy of DHHS's notice. Prohibits requiring prepaid health plans or LME/MCOs from otherwise reimbursing the provider for services provided for which payment is suspended.
Makes conforming organizational changes to renumber the act's remaining Sections.
Makes conforming and clarifying changes, and adds to, the certain portions of SL 2015-245 to be codified into new Article 4, Prepaid Health Plans, GS Chapter 108D. Modifies and adds to the authorizations granted to the Revisor in codifying those specified portions.
Makes technical and clarifying changes.
Makes clarifying changes.
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