Health Plan Provider Contract Bill

Senate Bill 877 has been filed by Senator Clodfelter requiring that contracts between health plans and physicians contain certain provisions.  Key provisions of the bill include: (1) requiring contracts to contain important physician protections found in NC law, (2) contracts shall  specify termination and amendment provisions, (3) “authorization vendors” and “rental networks” must be listed, (4) EOBs must contain elements such that the patient will clearly understand his/her financial responsibility (5) A summary disclosure form must be made available.  The specific requirements were developed by the NC Medical Group Managers, who worked on the concepts behind the legislation during 2008 and surveyed its members to establish priorities.
 
 

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1 Comment

  • Deepak R. Gelot, MD

    NCMS/AMA/AAFP/NCAFP should work together for a standardized MCO-Provider contract in NC, similar to Colorado SB79(see CMS.org) ASAP.
    Has any one looked at and reviewed NEW NC BCBS provider contract sent to Primary care practices last month?
    ANY comments regarding language and new fee schedule?