A BILL TO BE ENTITLED
AN ACT TO DIRECT THE EXECUTIVE ADMINISTRATOR OF THE TEACHERS' AND STATE EMPLOYEES' COMPREHENSIVE MAJOR MEDICAL PLAN TO INITIATE OR CONTINUE CERTAIN DISEASE MANAGEMENT ACTIVITIES, AS RECOMMENDED BY THE HOUSE SELECT COMMITTEE ON THE RISING COST OF HEALTH CARE.
The General Assembly of North Carolina enacts:
SECTION 1.  The Executive Administrator of the Teachers' and State Employees' Comprehensive Major Medical Plan shall do the following to address the rising cost of health care covered under the Plan:
(1)	Develop a program to more effectively publicize and promote disease management activities to Plan members.
(2)	Enhance current efforts to manage diseases, claims, and usage by high‑risk and potential high‑risk Plan members.
(3)	Develop incentives to encourage participation by providers of health care services and Plan members in disease management programs. These incentives may include:
a.	Offering additional or enhanced benefits under the Plan to those who participate in disease management.
b.	Offering incentives to providers in the form of case management fees or additional service payments.
c.	Reward providers that meet nationally recognized quality of care guidelines.
(4)	Ensure that the Plan's disease management activities include adequate technological capabilities to identify high‑cost and potential high‑cost patients, manage comorbidities, and enhance communication between patients and providers.
(5)	Publicize performance measures that are linked to standardized health status indicators and use the performance measures to justify enhanced reimbursements to providers and to target State resources for enhancing the Plan's reimbursements to providers of health care services.
(6)	Adopt contractual agreements with providers that require and reward evidence‑based practice standards and guidelines for the Plan and for NC Health Choice.
SECTION 2.  This act is effective when it becomes law.