North Carolina General Statutes 58-50-57. Offsets against provider reimbursement for workers’ compensation payments forbidden
Terms Used In North Carolina General Statutes 58-50-57
- Contract: A legal written agreement that becomes binding when signed.
- Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
(a) An insurer that provides a health benefit plan as defined in N.C. Gen. Stat. § 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 for which the employee, employer, or carrier is liable or responsible according to a final adjudication of the claim under the Workers’ Compensation Act, Article 1 of Chapter 97 of the N.C. Gen. Stat. or 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 N.C. Gen. Stat. § 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 for which the employee, employer, or carrier is liable or responsible according to a final adjudication of the claim under the Workers’ Compensation Act, Article 1 of Chapter 97 of the N.C. Gen. Stat. or an order of the North Carolina Industrial Commission approving a settlement agreement entered into under that Article. (2001-216, s. 5; 2001-487, s. 102(b).)