Legislative Update 2010

New Bills Passed in North Carolina affecting Health Laws

Update of Health Care Reform

Legislative Update

2010 Short Session convened May 2010 & ended July 2010

778 bills filed 227 laws enacted 2011 Session will convene January 2011

Legislative Update

Insurance and State Health Plan Cover/Hearing Aids/Autism S.L. 2010-2

Requires health benefit plans and the State Health Plan to cover medically necessary hearing aids and services that are ordered by physician or audiologist

Legislative Update

State Health Plan/Age-Out Dependent: Tobacco Use Testing

Dependent Child enrolled in State Health Plan as of May 1, 2010, remain in plan through the end of the month following the child’s 26th birthday, provided not eligible for other employer-sponsored health benefit coverage

Legislative Update

No Set Fee/Non-Covered Dental Services SL2010-138 prohibits health benefit plans

and insurers from limiting or fixing the fee dentists may charge patients for services unless those services are covered for reimbursement under the plan or insurer contract with the dentist

Legislative Update

SL 2010-185 amends GS108A-63 make it unlawful for any person to solicit or receive remuneration in return for referring any individual to a person for the furnishing of any item or service subject to reimbursement by Medicaid. It also makes it unlawful to offer or pay remuneration for such referrals or purchases, leases or orders.

Legislative Update

Low Profit Limited Liability Company SL 2010-187 recognizes formation of a L3C

and may designate it in bylaws. Must accomplish one or more of the charitable or education purposes within the meaning of Section 170(c)(2)(B) of the Internal Revenue Code

Legislative Update

Patient Protection and Affordable Care Act Passed December 24, 2009 Obama Care

Legislative Update

Every working American must have health insurance by 2014

Penalty for not purchasing health insurance except for certain individuals

Poor people, Native Americans, hardship cases, religious convictions, illegal aliens and people in jail

Legislative Update

Employers with more than 200 full-time employees must automatically enroll new hirees in health plan

May opt out Must notify employees about government

health insurance exchange program and tax credits, employee chooses government exchange employer will not contribute to it.

Legislative Update

Large employers must file report on the health insurance coverage they provide

Must disclose their share of costs of benefits to employees

Legislative Update

Provides tax credits to small employers with 25 or fewer full-time employees and average annual wages of no more than $50,000 that purchase health insurance for their employees

Legislative Update

Cannot exclude for pre-existing condition for children

Provide coverage of certain preventative health services

Eliminate lifetime limits on benefits and restricts on annual limits on benefits

Children to have coverage up to age 26

Legislative Update

Cannot discriminate against any plan carrier or individual that chooses not to cover assisted death in any form

No regulation under bill will bar individual from getting care

No employer can discriminate against employee who is getting federal health insurance assistance

Legislative Update

Guaranteed issue and renewability of coverage

States may form compacts for interstate sale of insurance

Enrollees may select primary care provider -no prior authorization for emergency services and direct access to OB/GYN care

Legislative Update

Medicaid is expanded to all individuals under age 65 with incomes up to 133% of the federal poverty level

Provides 100% federal funding to states for costs of newly eligible individuals for 2014-2016

Primary Care services will be reimbursed at 100% of the Medicare payment rates for 2013 and 2014

Legislative Update

Karen McKeithen Schaede Attorney at Law PLLC

www.shadylaw.net 336-288-4055

Questions