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NC H134
Bill
Status
2/15/2023
Primary Sponsor
Edward Goodwin
Click for details
AI Summary
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Allows the North Carolina State Health Plan for Teachers and State Employees to access and use claims payment data from claims processors while maintaining confidentiality protections.
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Requires claims processors to provide the Plan with claim payment data on a monthly basis, including data reflecting rates negotiated with non-contracted third parties, or provide sufficient documentation if data cannot be obtained.
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Voids any contract provisions that prevent claims processors from disclosing claim payment data to the Plan, but restricts such disclosure only to the Plan itself.
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Limits the Plan's use of claim payment data to administering the State Health Plan and prohibits using provider data to negotiate rates with that provider or others.
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Restricts standing to enforce the section to only the Plan and the Claims Processor, and provides claims processors immunity from civil liability for compliant disclosures.
Legislative Description
SHP Claims Administrator Changes.-AB
Health; Public; Salaries & Benefits; State Employees; Teachers; State Health Plan
Last Action
Re-ref Com On Health
3/23/2023