North Carolina § 135-48 - 51. (Effective until January 1, 2022) Coverage and operational mandates related to Chapter 58 of the General Statutes.

§ 135-48. 51. (Effective until January 1, 2022) Coverage and operational mandates related to Chapter 58 of the General Statutes.

The following provisions of Chapter 58 of the General Statutes apply to the State Health Plan: G.S. 58-3-191, Managed care reporting and disclosure requirements. G.S. 58-3-221, Access to nonformulary and restricted access prescription drugs. G.S. 58-3-223, Managed care access to specialist care. G.S. 58-3-225, Prompt claim payments under health benefit plans. G.S. 58-3-235, Selection of specialist as primary care provider. G.S. 58-3-240, Direct access to pediatrician for minors. G.S. 58-3-245, Provider directories. G.S. 58-3-250, Payment obligations for covered services. G.S. 58-3-265, Prohibition on managed care provider incentives. G.S. 58-3-280, Coverage for the diagnosis and treatment of lymphedema. G.S. 58-3-285, Coverage for hearing aids. G.S. 58-50-30, Right to choose services of certain providers. G.S. 58-67-88, Continuity of care. G.S. 58-3-247, Insurance identification card. History (2011-85, s. 2.10; 2012-129, s. 2; 2013-296, s. 3; 2013-324, s. 5.) Effect of Amendments. - Session Laws 2012-129, s. 2, effective October 1, 2012, inserted "physical therapist" in subdivision (12). Session Laws 2013-296, s. 3, effective October 1, 2013, rewrote subdivision (12), which formerly read "G.S. 58-50-30, Right to choose services of optometrist, podiatrist, licensed clinical social worker, certified substance abuse professional, licensed professional counselor, dentist, physical therapist, chiropractor, psychologist, pharmacist, certified fee-based practicing pastoral counselor, advanced practice nurse, licensed marriage and family therapist, or physician assistant." Session Laws 2013-324, s. 5, effective July 23, 2013, rewrote subdivision (9), which formerly read "G.S. 58-3-265, Payment obligations for covered services." § 135-48.51. Coverage and operational mandates related to Chapter 58 of the General Statutes. The following provisions of Chapter 58 of the General Statutes apply to the State Health Plan: (1) G.S. 58-3-191 , Managed care reporting and disclosure requirements. (2) G.S. 58-3-221 , Access to nonformulary and restricted access prescription drugs. (3) G.S. 58-3-223 , Managed care access to specialist care. (4) G.S. 58-3-225 , Prompt claim payments under health benefit plans. (5) G.S. 58-3-235 , Selection of specialist as primary care provider. (6) G.S. 58-3-240 , Direct access to pediatrician for minors. (7) G.S. 58-3-245 , Provider directories. (8) G.S. 58-3-250 , Payment obligations for covered services. (9) G.S. 58-3-265 , Prohibition on managed care provider incentives. (10) G.S. 58-3-280 , Coverage for the diagnosis and treatment of lymphedema. (11) G.S. 58-3-285 , Coverage for hearing aids. (12) G.S. 58-50-30 , Right to choose services of certain providers. (13) G.S. 58-67-88 , Continuity of care. History (2011-85, s. 2.10; 2012-129, s. 2; 2013-296, s. 3; 2013-324, s. 5; 2021-30, s. 1(b).) Editor's Note. - Session Laws 2021-30, s. 2, made subdivision (7a), as added by Session Laws 2021-30, s. 1(b), effective January 1, 2022, and applicable to contracts entered into, amended, or renewed on or after that date. Effect of Amendments. - Session Laws 2012-129, s. 2, effective October 1, 2012, inserted "physical therapist" in subdivision (12). Session Laws 2013-296, s. 3, effective October 1, 2013, rewrote subdivision (12), which formerly read "G.S. 58-50-30, Right to choose services of optometrist, podiatrist, licensed clinical social worker, certified substance abuse professional, licensed professional counselor, dentist, physical therapist, chiropractor, psychologist, pharmacist, certified fee-based practicing pastoral counselor, advanced practice nurse, licensed marriage and family therapist, or physician assistant." Session Laws 2013-324, s. 5, effective July 23, 2013, rewrote subdivision (9), which formerly read "G.S. 58-3-265, Payment obligations for covered services." Session Laws 2021-30, s. 1(b), added subdivision (7a). For effective date and applicability, see editor's note.