NC S174

Expands the definition of "Claim Payment Data" under the North Carolina State Health Plan to include negotiated rates agreed to by providers, in addition to billed amounts and allowed amounts.

Requires claims processors to provide the State Health Plan with all Claim Payment Data at least monthly, including member-level disclosure for claims paid with state funds.

Voids any contract provisions that prevent claims processors from disclosing Claim Payment Data to the Plan, while protecting the Plan's ability to maintain data confidentiality.

Restricts the Plan's use of Claim Payment Data solely to administering the State Health Plan, prohibiting use for rate negotiations and requiring restrictive contracts with any third parties granted access to the data.

Exempts Claim Payment Data from public records disclosure requirements under Chapter 132 of the General Statutes and shields claims processors from civil liability for compliant disclosures; effective January 1, 2022.