GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 2013

H                                                                                                                                                   2

HOUSE BILL 247

Committee Substitute Favorable 3/27/13

Short Title:        Freedom to Negotiate Health Care Rates.	(Public)
Sponsors:
Referred to:

March 7, 2013

A BILL TO BE ENTITLED

AN ACT to allow Health providers and health insurers to freely negotiate Reimbursement rates by prohibiting contract provisions that restrict rate negotiations.

The General Assembly of North Carolina enacts:

SECTION 1.  Part 7 of Article 50 of Chapter 58 of the General Statutes is amended by adding a new section to read:

"§ 58-50-295.  Prohibited contract provisions related to reimbursement rates.

No contract with a health care provider shall do any of the following:

(1) Prohibit, or grant a health insurance carrier an option to prohibit, the provider from contracting with another health insurance carrier to provide health care services at a rate that is equal to or lower than the payment specified in the contract.

(2) Require the provider to accept a lower payment rate in the event that the provider agrees to provide health care services to any other health insurance carrier at a rate that is equal to or lower than the payment specified in the contract.

(3) Require, or grant a health insurance carrier an option to require, termination or renegotiation of an existing health care contract in the event that the provider agrees to provide health care services to any other health insurance carrier at a rate that is equal to or lower than the payment specified in the contract.

(4) Require, or grant a health insurance carrier an option to require, the provider to disclose, directly or indirectly, the provider's contractual rates with another health insurance carrier.

(5) Require, or grant a health insurance carrier an option to require, the nonnegotiated adjustment by the issuer of the provider's contractual rate to equal the lowest rate the provider has agreed to charge any other health insurance carrier.

(6) Require, or grant a health insurance carrier an option to require, the provider to charge another health insurance carrier a rate that is equal to or more than the reimbursement rate specified in the contract."

SECTION 2.  This act becomes effective October 1, 2013, and applies to contracts entered into, renewed, or amended on or after that date. Neither this act nor any legislative history of its passage shall be construed to affect any litigation pending at the time this act becomes effective.