GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2001
H	1
HOUSE BILL 1045
     

 
Short Title:	Restore Worker's Comp. Stability.	()	
Sponsors:	Representatives Baddour;  Alexander, Blue, Daughtry, Dedmon, Dockham, Fitch, Gibson, Goodwin, Hackney, McComas, Michaux, Mitchell, Pope, Smith, Thompson, Wainwright, and Weiss.	
Referred to:	Insurance.	
April 10, 2001

A BILL TO BE ENTITLED
AN ACT to restore stability under the workers' compensation act by overturning the case decided by the 2000 court of appeals of north carolina entitled Hansen v. crystal ford-mercury, inc., by providing that insurers that provide health benefit plans, disability income plans, or any other health insurance are not real parties in interest in any proceeding or settlement under the workers' compensation act and prohibiting insurers that provide health benefit plans from offsetting against provider reimbursement any charge for medical services unless the specific medical charges were found to be compensable according to a final adjudication under the workers' compensation act or a settlement agreement under the act approved by the north carolina industrial Commission.

The General Assembly of North Carolina enacts:
SECTION 1.  Article 1 of Chapter 97 of the General Statutes is amended by adding a new section to read:
"§ 97-90.1. Insurers that provide employee's health benefit plans, disability income plans, or any other health insurance plans. 
An insurer that covers an employee under a health benefit plan as defined in G.S. 58-3-167, a disability income plan, or any other health insurance plan is not a real party in interest and shall not intervene or participate in any proceeding or settlement agreement under this Article to determine whether a claim is compensable under this Article or to seek reimbursement for medical payments under its plan. The insurer that covers an employee under a health benefit plan as defined in G.S. 58-3-167, a disability income plan, or any other health insurance plan may seek reimbursement from an employee, employer, or carrier for only health plan payments for specific medical charges that have been finally adjudicated to be compensable under this Article or have been found to be compensable according to an order of the Commission approving a settlement agreement entered into under this Article."
SECTION 2.  G.S. 97‑92 reads as rewritten:
"(b)	The records of the Commission, insofar as they refer to accidents, injuries, and settlements are not public records under G.S. 132-1 and shall not be open to the public, but only to the parties satisfying the Commission of their interest in such records and the right to inspect them, and to State and federal agencies pursuant to G.S. 97‑81."
SECTION 3.  G.S. 58‑51‑5(a) is amended by adding a new subdivision to read:
"(8)	It contains no provision excluding from coverage claims that are subject to the Workers' Compensation Act, Article 1 of Chapter 97 of the General Statutes, unless the exclusion extends to only specific medical charges that have been finally adjudicated to be compensable under that Article or have been found to be compensable according to an order of the North Carolina Industrial Commission approving a settlement agreement entered into under that Article."
SECTION 4.  Article 50 of Chapter 58 of the General Statutes is amended by adding a new section to read:
"§ 58-50-57.  Offsets against provider reimbursement for workers' compensation payments forbidden.
(a)	An insurer that provides a health benefit plan as defined in G.S. 58-3-167 shall not offset or reverse a health plan payment against a provider reimbursement for other medical charges unless the health plan payment was for a specific medical charge that had been finally adjudicated to be compensable under the Workers' Compensation Act, Article 1 of Chapter 97 of the General Statutes, or had been found to be compensable according to an order of the North Carolina Industrial Commission approving a settlement agreement entered into under that Article.
(b)	No contract between an insurer that provides a health benefit plan as defined in G.S. 58-3-167 and a medical provider shall contain a provision that authorizes the insurer to offset or reverse a health plan payment against a provider reimbursement for other medical charges unless the health plan payment was for a specific medical charge that had been finally adjudicated to be compensable under the Workers' Compensation Act, Article 1 of Chapter 97 of the General Statutes, or had been found to be compensable according to an order of the North Carolina Industrial Commission approving a settlement agreement entered into under that Article."
SECTION 5.  This act is effective when it becomes law.