Senate committee substitute amends the 1st edition as follows.
Modifies new GS 58-3-295 to eliminate the proposed procedure under which an insurer may recover overpayments made to the health care provider or facility under the new statute. Makes conforming organizational changes.
MEDICAL BILLING TRANSPARENCY.
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View NCGA Bill Details | 2021 |
AN ACT TO PREVENT NORTH CAROLINIANS FROM BECOMING VICTIMS OF SURPRISE BILLING BY OUT-OF-NETWORK HEALTH CARE PROVIDERS THAT HAVE RENDERED HEALTH CARE SERVICES AT HEALTH SERVICES FACILITIES THAT ARE IN-NETWORK WITH AN INDIVIDUAL'S HEALTH BENEFIT PLAN.Intro. by Krawiec, Burgin, Perry.
Bill History:
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Mon, 5 Apr 2021 Senate: Filed
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Tue, 6 Apr 2021 Senate: Passed 1st Reading
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Tue, 6 Apr 2021 Senate: Ref To Com On Rules and Operations of the Senate
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Tue, 13 Apr 2021 Senate: Withdrawn From Com
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Thu, 22 Apr 2021 Senate: Reptd Fav Com Substitute
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Thu, 22 Apr 2021 Senate: Com Substitute Adopted
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Thu, 22 Apr 2021 Senate: Re-ref Com On Commerce and Insurance
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Thu, 29 Apr 2021 Senate: Reptd Fav
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Thu, 29 Apr 2021 Senate: Re-ref Com On Rules and Operations of the Senate
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Tue, 4 May 2021 Senate: Reptd Fav
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Tue, 4 May 2021 Senate: Reptd Fav
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Wed, 5 May 2021 Senate: Amend Tabled A1
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Wed, 5 May 2021 Senate: Amend Tabled A2
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Wed, 5 May 2021 Senate: Passed 2nd Reading
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Wed, 5 May 2021 Senate: Passed 3rd Reading
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Thu, 6 May 2021 Senate: Regular Message Sent To House
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Thu, 6 May 2021 House: Regular Message Received From Senate
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Mon, 10 May 2021 House: Passed 1st Reading
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Mon, 10 May 2021 House: Ref To Com On Rules, Calendar, and Operations of the House
Bill Summaries:
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Bill S 505 (2021-2022)Summary date: Apr 22 2021 - View Summary
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Bill S 505 (2021-2022)Summary date: Apr 5 2021 - View Summary
Includes whereas clauses.
Enacts new GS 58-3-295 to require all contracts or agreements for participation as an in-network health services facility between an insurer offering health benefit plans in this state and a health services facility at which there are out-of-network providers who may be providing services to an insured person receiving care at the facility, to require that an in-network health services facility give at least 72 hours' advanced written notice to an insured with a scheduled appointment of any out-of-network provider who will be part of providing care. Sets out alternate requirements for timing of notice in situations in which there is not 72 hours between the appointment and when it is scheduled or when there is an emergency. Requires the notice to include: (1) all of the health care providers that will be rendering services who are not in-network and (2) the estimated cost to the insured of the services being rendered by those out-of-network providers. Sets out the procedure under which an insurer may recover overpayments made to the provider or facility. Defines a health care provider as any individual licensed, registered, or certified under GS Chapter 90, or under another state's laws, to provide health care services in the ordinary care of business or practice, as a profession, or in an approved education or training program in: (1) anesthesia or anesthesiology, (2) emergency services, (3) pathology, (4) radiology, or (5) rendering assistance to a physician performing any of these services.
Applies to contracts entered into, amended, or renewed on or after January 1, 2022.