NC S161

Replaces terminology of "managed care action" with "adverse benefit determination" throughout North Carolina's LME/MCO grievances and appeals statutes to conform with federal regulations in 42 C.F.R. § 438.400(b).

Extends the deadline for filing standard LME/MCO level appeals from 30 days to 60 days after mailing of the notice of adverse benefit determination.

Reduces the LME/MCO standard appeal resolution deadline from 45 days to 30 days after receiving the appeal request.

Changes expedited appeal resolution timeframe from "three working days" to "72 hours" after receiving the expedited appeal request.

Extends the deadline for filing a contested case hearing request with the Office of Administrative Hearings from 30 days to 120 days after mailing of the notice of resolution.