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Legislative Update 2010

Legislative Update 2010

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Legislative Update 2010

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  1. Legislative Update 2010

  2. Legislative Update • New Bills Passed in North Carolina affecting Health Laws • Update of Health Care Reform

  3. Legislative Update • 2010 Short Session convened May 2010 & ended July 2010 • 778 bills filed • 227 laws enacted • 2011 Session will convene January 2011

  4. 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

  5. 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

  6. 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

  7. 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.

  8. 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

  9. Legislative Update • Patient Protection and Affordable Care Act • Passed December 24, 2009 • Obama Care

  10. 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

  11. 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.

  12. Legislative Update • Large employers must file report on the health insurance coverage they provide • Must disclose their share of costs of benefits to employees

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. Questions • Karen McKeithen SchaedeAttorney at Law PLLC • www.shadylaw.net • 336-288-4055