A BILL TO BE ENTITLED
AN ACT to require payments be made directly to health care providers under reimbursement contracts and to make other statutory changes related to those contracts and to assignment of benefits agreements.
The General Assembly of North Carolina enacts:
SECTION 1.  Article 3 of Chapter 58 of the General Statutes is amended by adding a new section to read:
"§ 58‑3‑226.  Reimbursement contracts and assignment of benefits.
(a)	The following definitions apply in this section:
(1)	Health benefit plan. – As defined in G.S. 58‑3‑167. The phrase also applies to limited‑scope dental and vision insurance.
(2)	Health care provider. – As defined in G.S. 58‑3‑225.
(3)	Insured. – An individual who is eligible to receive benefits from the health benefit plan.
(b)	Reimbursement Contracts. – A reimbursement contract between a health care provider and an insurer or a third‑party payor shall require that reimbursement shall be made directly to the health care provider for any covered service provided by the health care provider under the reimbursement contract.
(c)	Assignment of Benefits. – An insurer or a third‑party payor shall accept and honor a completed assignment of benefits agreement that assigns the insured's reimbursement benefits to a health care provider. The assignment of benefits agreement must be validly executed by the insured. This subsection applies only if there is no reimbursement contract between a health care provider and an insurer or a third‑party payor.
(d)	The prompt claims payment provisions under G.S. 58‑3‑225 apply to payments made under reimbursement contracts or through an assignment of benefits agreement."
SECTION 2.  This act is effective July 1, 2019, and applies to reimbursement contracts and assignment of benefit agreements entered into or amended on or after that date.