NC H434

Hospitals and ambulatory surgical facilities must submit quarterly reports to a statewide data processor on pricing for the 100 most frequently reported inpatient DRGs and the 20 most common surgical and imaging procedures, including charges for uninsured patients, negotiated rates, and Medicare/Medicaid reimbursements

Health service facilities and out-of-network healthcare providers must provide written disclosure to insured patients identifying nonparticipating providers and warning that certain consumer protections may not apply when receiving care from out-of-network providers

Facility fees are prohibited for outpatient evaluation and management services, diagnostic services, and imaging services, and may only be charged for services provided on a hospital's main campus, at remote hospital locations, facilities with emergency departments, or ambulatory surgical facilities

Prior authorization requirements are updated to require insurers to render determinations within three business days for non-urgent services and 24 hours for urgent services, and artificial intelligence cannot be used as the sole basis to deny a utilization review determination

Certificate of Need review requirements are eliminated for inpatient rehabilitation services, rehabilitation facilities, and rehabilitation beds