GENERAL ASSEMBLY OF NORTH CAROLINA
1995 SESSION
CHAPTER 548
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 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. 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 or insurer,
managed care organization 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.
In the General Assembly read three times and ratified this the 28th day of May, 1996.
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Dennis A. Wicker
President of the Senate
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Harold J. Brubaker
Speaker of the House of Representatives