NORTH CAROLINA GENERAL ASSEMBLY
1975 SESSION
CHAPTER 345
SENATE BILL 509
AN ACT TO PROHIBIT THE EXCLUSION OF SICKNESS AND ACCIDENT BENEFITS FOR PATIENTS RECEIVING MEDICAL CARE IN STATE TAX-SUPPORTED FACILITIES WHEN BENEFITS WOULD OTHERWISE BE PAYABLE.
The General Assembly of North Carolina enacts:
Section 1. Article 26 of Chapter 58 of the General Statutes of North Carolina is hereby amended by adding a new section thereto to be designated G.S. 58-251.7 and to read as follows:
"§ 58-251.7. Insurers and others to afford coverage for active medical treatment in tax-supported institutions. — (a) No policy providing benefits for charges of hospitals or physicians shall be delivered, issued, executed or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Insurance, after the effective date of this section unless such policy provides for the payment of benefits for charges made for medical care rendered in or by duly licensed State tax-supported institutions, including charges for medical care of cerebral palsy, other orthopedic and crippling disabilities, mental and nervous diseases and disorders, mental retardation, alcoholism and drug or chemical dependency, and respiratory illness, on a basis no less favorable than the basis which would apply had the medical care been rendered in or by any other public or private institution or provider. The term 'State tax-supported institutions' shall include community mental health centers and other health clinics which are certified as Medicaid providers.
(b) No policy shall exclude payment for charges of a duly licensed State tax-supported institution because of its being a specialty facility for one particular type of illness nor because it does not have an operating room and related equipment for the performance of surgery, but it is not required that benefits be payable for domiciliary or custodial care, rehabilitation, training, schooling, or occupational therapy.
(c) The restrictions and requirements of this act shall not apply to any policy which is individually underwritten or provided for a specific individual and the members of his family as a nongroup policy, but shall apply only to those group policies of insurance delivered, issued for delivery, reissued or renewed in this State on and after July 1, 1975."
Sec. 2. Chapter 57 of the General Statutes of North Carolina is hereby amended by adding a new section thereto to be designated G.S. 57-7.1 and to read as follows:
"§ 57-7.1. Coverage for active medical treatment in tax-supported institutions. — (a) No hospital or medical or dental service plan, contract or certificate governed by the provisions of Chapter 57 of the General Statutes of North Carolina shall be delivered, issued, executed or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Insurance, after the effective date of this section unless such plan, contract or certificate provides for the payment of benefits for charges made for medical care rendered in or by duly licensed State tax-supported institutions, including charges for medical care of cerebral palsy, other orthopedic and crippling disabilities, mental and nervous diseases and disorders, mental retardation, alcoholism and drug or chemical dependency, and respiratory illness, on a basis no less favorable than the basis which would apply had the medical care been rendered in or by any other public or private institution or provider. The term 'State tax-supported institutions' shall include community mental health centers and other health clinics which are certified as Medicaid providers.
(b) No plan, contract, or certificate shall exclude payment for charges of a duly licensed State tax-supported institution because of its being a specialty facility for one particular type of illness nor because it does not have an operating room and related equipment for the performance of surgery, but it is not required that benefits be payable for domiciliary or custodial care, rehabilitation, training, schooling, or occupational therapy.
(c) The restrictions and requirements of this act shall not apply to any plan, contract, or certificate which is individually underwritten or provided for a specific individual and the members of his family as a nongroup policy, but shall apply only to those hospital service and medical service subscriber plans, contracts, or certificates delivered, issued for delivery, reissued or renewed in this State on and after July 1, 1975."
Sec. 3. This act shall become effective upon ratification.
In the General Assembly read three times and ratified, this the 21st day of May, 1975.