NC Health Plans Must Disclose Policy Changes Before Implementation

August 7, 2003 (PLANSPONSOR.com) - Health benefit plans in North Carolina must now disclose to contract providers their fee and claims submission schedules and reimbursement policies before implementation.

>The new requirement comes courtesy of HB 1066 that was recently signed into law by Governor Mike Easley.   The notification requirement is designed, according to the text of the bill, to assist in the submission of complete claims by providers, according to Washington-based legal publisher BNA.

>Minimum information required to be in the notices and disclosures is included in the legislation. Insurers also are required to submit to the state Insurance Department a written description of the policies and procedure they will use to implement the new law.

Other Bills

>Also inked by the Democratic governor was HB 886, legislation targeted to improve due process for physicians in the state. Under the terms of the bill, the governor is authorized to appoint to the state medical board a North Carolina medical school doctor that uses “integrative medicine” – a diagnostic or therapeutic treatment that may not be considered a conventionally accepted medical treatment, but that a licensed physician believes may be of potential benefit to a patient and which does not pose any greater risk than comparable conventional treatments.

>This board, under the terms of the bill, is required to encompass members that reflect North Carolina’s population in terms of age, ethnicity, race, and gender. Further, the board will be required to consider certain evidence and testimony prior to suspending, denying, or revoking a medical license and must consult with a licensee that practices integrative medicine before taking punitive action against another practitioner of integrative medicine.

Text of the new laws is available from the Legislature’s Web site at www.ncga.state.nc.us under NC Session Laws.

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