GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 1995

H	1 

HOUSE BILL 1088*

Short Title:  Hospital Reimbursement.	(Public)

─────────────────────────────────────── 
Sponsors: Representatives Lemmond; Thompson and Sharpe.

─────────────────────────────────────── 
Referred to:  Insurance.

─────────────────────────────────────── 

May 14, 1996

A BILL TO BE ENTITLED
AN ACT TO CHANGE THE REQUIREMENT FOR HOSPITAL REIMBURSEMENT IN WORKERS' COMPENSATION CASES.
The General Assembly of North Carolina enacts:
Section 1.  G.S. 97-26(b) reads as rewritten: 
"(b)	Hospital Fees. – Payment for medical compensation rendered by a hospital participating in the State Plan, except as otherwise provided herein, shall be equal to the payment the hospital receives for the same treatment and services under the State Plan, provided that such payment with respect to inpatient hospital services shall not be less than ninety percent (90%) nor more than one hundred percent (100%) of the hospital's itemized charges as shown on the UB-92 claim form. A hospital's itemized charges on the UB-92 claim form for workers' compensation services shall be the same as itemized charges for like services for all other payors during the period from April 1, 1996, through June 30, 1997.  Payment for a particular type of medical compensation that is not covered under the State Plan shall be based on the allowable charge under the State Plan for comparable services or treatment, as determined by the Commission.  Each hospital subject to the provisions of this subsection shall be reimbursed the amount provided for in this subsection unless it has agreed under contract with the insurer, managed care organization, or employer to accept a different amount or reimbursement methodology."
Sec. 2.  This act becomes effective April 1, 1996, and applies to hospital inpatient admissions occurring on or after that date.  This act expires on June 30, 1997, and its expiration applies to all hospital inpatient admissions occurring on or after that date.