Bill Summary for H 161 (2023-2024)

Printer-friendly: Click to view

Summary date: 

Apr 19 2023

Bill Information:

View NCGA Bill Details2023-2024 Session
House Bill 161 (Public) Filed Tuesday, February 21, 2023
Intro. by Stevens.

View: All Summaries for BillTracking:

Bill summary

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

Amends GS 8-58.1(a) (injured party as witness when medical charges at issue) as follows. Specifies that the testimony of a person pursuant to GS 8-58.1 establishes a rebuttable presumption of the reasonableness of the amount paid or required to be in paid in full satisfaction of the charges.  

Amends GS 8-58.1(b) to now provide that if the injured party has health insurance that will, if filed by a particular health care provider (was, just provider), result in a reduction in the charge due to a contractual adjustment being taken by the provider, and such health insurance (was, just insurance) is filed  and no lien as set forth in GS 44-49 or GS 44-50 has been asserted, then the evidence as to the amount of the bill will be the amount paid by all sources and all amounts remaining to be paid. Now specifies that if a lien under GS 44-49 or GS 44-50 has been asserted, regardless of any defenses against the lien (previously, no mention of defenses against the lien), and the injured party has no health insurance or no health insurance (was, insurance) has been filed, then the evidence as to the amount of the charge that may be introduced in an action tried in the courts of North Carolina is the amount of the claimed lien plus any amounts paid toward the balance of  the original charges and any amounts due not included in the lien (was, just the amount of the claimed lien). Now provides that if the injured party is covered by Medicare, Medicaid, or any health plan or program (was, just Medicare and Medicaid), and such benefit provider chooses to pay the claim, the evidence of the amount of the charge shall be the amount actually paid by the benefit provider and, if any, the amount paid by or on behalf of the injured party from any source  and any amount left unpaid. Specifies that the rule does not impose upon the inured party an affirmative duty to seek a reduction in billed charges or submission of charges to a health insurer. 

Makes organizational and technical changes to GS 44-49(b) (pertaining to certain medical liens).

Amends the unfair claims settlement practices set forth in GS 58-63-15(11) (unfair competition and unfair trade practices in insurance) as follows.  Changes new GS 58-63-15(11)(p) so that the unfair practice is attempting to calculate the amount of a health care provider charge for the purpose of determining damages in a claim by a method other than that set forth in GS 8-58.1 as amended (previously applied to medical provider charges for a purpose other than an action tried in the State with certain exceptions). Adds new GS 58-63-15(11)(q) making it an unfair practice to apply GS 8C-1, Rule 414 or GS 8-58.1 to calculate a health care provider charge in any matter governed by Article 45C of GS Chapter 1, Revised Uniform Arbitration Act, or not governed by the Rules of Evidence.

Makes conforming changes to act’s long title.