Bill Information for Session 117 - South Carolina
House Rule 493- Genetic Information Nondiscrimination Act of 2008
On May 21, 2008, House Rule 493 known as the Genetic Information Nondiscrimination Act of 2008 was signed into law by the President. This Act makes changes to the HIPAA portability rules in ERISA, the PHSA, and the Code, adding new provisions regarding genetic information that will apply to group health plans and insurance issuers offering group health insurance coverage, as well as provisions for insurance issuers in the individual market. It also requires amendments to the HIPAA privacy regulations and prohibits discrimination in the workplace on the basis of genetic information.
For a copy of the legislation Click HereIn South Carolina, prompt pay legislation has once again been re-introduced in the form of Senate bill 974. This is pending legislation and to view it, CLICK HERE.The North Carolina Department of Insurance Life and Health Division has released a summary of the 2007 Regular Session Legislation. This summary annotated and addresses the legislation from a Carrier standpoint. This summary can be accessed by CLICKING HERE.
The summary also lists a contact person for any questions regarding this summary.
Below are Bills that passed in the South General Assembly in the 2008 Session that may impact your business in South Carolina.SB 1109A joint resolution to approve regulations of the budget and control board, relating to data reporting requirements pertaining to south carolina hospitals, designated as regulation document number 3179, pursuant to the provisions of article 1, chapter 23, title 1 of the 1976 code. Has amended the regulations that provide for establishing procedures and standards for reporting health care data from South Carolina hospitals requiring a Certificate of Need. The amendments will update the standards by which South Carolina hospitals submit health care data, requiring a monthly submission of data as opposed to a quarterly submission.
Below are Bills that passed in the North Carolina General Assembly in the 2007 Session that may impact your business in North Carolina.
HB 731 Revision of the Life and Health Insurance Laws
HB 818 Amend the Practice of Medicine Laws
SB 1032 Health Insurance /Prompt Pay Timelines
NC House Bill HB 973 - Mental Health Equitable Coverage
NC House Bill 265- Establish High Risk Pool
NC House Bill 748- Emergency PrescriptionsHB 731 Revision of the Life and Health Insurance Laws
An act to protect consumers purchasing annuity products; address portability in accident and health and life insurance; make minor changes in the laws on managed care external reviews; clarify definitions in long-term care insurance; address small employer carrier plan elections; define “critical period conversion ration” for credit insurance; make miscellaneous amendments to other provisions related to life and health insurance; and make technical corrections in insurance code references to the teachers’ and state employees’ major medical plan.
You can review House Bill 731 in its entirety online at www.ncga.state.nc.us. Enter H731 in the Bill Look-up feature.HB 818 Amend the Practice of Medicine Laws
An act to amend the laws pertaining to the practice of medicine. The North Carolina Medical Board (Board) is empowered to adopt rules that prescribe additional qualifications for an applicant, including education and examination requirements and application procedures. NOTE***SECTION 1. Article 1 of Chapter 90 of the General Statutes is amended by adding a new section to read:"§ 90 1A. Definitions.
The following definitions apply in this Article: (5) The practice of medicine or surgery. – The practice of medicine or surgery includes any of the following acts: (e) Rendering a determination of medical necessity or a decision affecting the diagnosis or treatment of a patient.You can review House Bill 818 in its entirety online at www.ncga.state.nc.us. Enter H818 in the Bill Look-up feature.
SB 1032 Health Insurance/Prompt Pay TimelinesAn act to impose time limitations on overpayment recovery under the prompt claim payments statute and to require that insurers offering health benefits plans provide insurance identification cards.
You can review Senate Bill in its entirety online at www.ncga.state.nc.us. Enter S1032 in the Bill Look-up feature.
North Carolina HB 973 - Mental Health Equitable Coverage
An Act to require mandatory health insurance coverage of certain mental illnesses and to require at least a minimum benefit package for other mental illnesses.You can review House Bil`l 973 in its entirety online at www.ncga.state.nc.us. Enter H973 in the Bill Look-up feature.
North Carolina House Bill 265- Establish High Risk Pool
This is an act to establish the North Carolina health insurance risk pool to provide access to health insurance coverage to certain individuals. The following section of the bill explains funding for the program
The Pool will assess all insurers in an amount not to exceed two dollars ($2.00) per covered individual insured or reinsured or for whom medical care benefits are administered by each insurer per month.
In addition to the assessment, the Pool may impose on each insurer a special assessment only when enrollment in the Pool has been capped or suspended. A special assessment may be made to cover only the additional losses of the Pool that are expected to result from the continued entry into the Pool by federally defined eligible individuals during the time that enrollment is closed to all other individuals eligible. The special assessment shall be based on actual or expected losses, actuarially appropriate reserves, and administrative expenses in excess of expected and collected premiums for the federally defined eligible individuals who enrolled or are expected to enroll while the suspension of enrollment is in effect.
The Pool shall assess each insurer an amount not to exceed the following limitations for each covered individual insured, reinsured, or for whom medical care benefits are administered, per month:
(1) Seventy cents (70¢) for the 2008 and 2009 calendar years.
(2) One dollar ($1.00) for the 2010 calendar year.
(3) One dollar and thirty cents ($1.30) for the 2011 calendar year.
(4) One dollar and seventy cents ($1.70) for the 2012 calendar year.
(5) Two dollars ($2.00) for the 2013 calendar year and all years thereafter.You can review House Bill 265 in its entirety online at www.ncga.state.nc.us. Enter H265 in the Bill Look-up feature.
North Carolina House Bill 748 - Emergency Prescriptions
North Carolina House Bill 748 has been ratified and is an act to cover extra prescriptions during a state of emergency or disaster.
You can review House Bill 748 in its entirety online at www.ncga.state.nc.us. Enter H748 in the Bill Look-up feature.
All health benefit plans that are licensed by the Department shall have when a declared state of disaster or state of emergency in North Carolina, a procedure in place to waive time restrictions on filling or refilling prescriptions for medication if requested by the covered person or subscriber.
The procedure shall include waiver or override of electronic "refill too soon" edits to pharmacies and shall include provision for payment to the pharmacy in accordance with the prescription benefit plan and applicable pharmacy provider agreement. The procedure shall enable covered persons or subscribers to:(1) Obtain one refill on a prescription if there are authorized refills remaining, or
(2) Fill one replacement prescription for one that was recently filled, as prescribed or approved by the prescriber of the prescription that is being replaced and not contrary to the dispensing authority of the dispensing pharmacy.
In an effort to make sure our payer partners are ready for the National Provider Identifier (NPI) MedCost would like to share an update on our progress with this effort. As you know, providers must begin using the NPI in all applicable standard electronic transactions by May 23, 2007.
MedCost is actively collecting the NPI from providers using the National Provider Identifier Submission Form. It is located on the Physicians and Providers section or you can go directly to the form. NPI Submission Form
Covered entities must be able to receive transactions with the NPI by the compliance date.
Coinciding with the compliance date, MedCost will have the capability to accept and transmit the NPI submitted on electronic claims. For payers that receive provider file information on a regular basis, MedCost will include a separate quarterly report listing the NPI of our participating network providers that have been captured by MedCost. The NPI will not be included in the existing provider data file. For additional information about the NPI, visit www.cms.hhs.gov/NationalProvIdentStand.
In an effort to support other covered entities that may have a need to establish a contingency plan for NPI compliance, MedCost, LLC will accept electronic transactions with and without the presence of an NPI after May 23, 2007.
Click Here for National Provider Identifier Information
Updated July 3, 2008