NC H169

Allows the North Carolina State Health Plan for Teachers and State Employees to access and utilize claims payment data from claims processors on a member level at least monthly frequency

Defines "Claim Payment Data" as information reflecting provider billing amounts, allowed amounts, and plan payments on claims, which may be treated as trade secrets if designated by the claims processor

Requires claims processors to provide claim payment data reflecting rates negotiated with non-contracted third parties upon request, or provide sufficient documentation supporting claim payments if data cannot be obtained

Voids any contract provisions that prevent claims processors from disclosing claim payment data to the Plan, and prohibits the Plan from using this data to negotiate rates with providers

Exempts claim payment data from public records disclosure requirements under Chapter 132 of the General Statutes and limits enforcement of these provisions to the Plan and the claims processor who submitted the data