§ 108A-54.3. Procedures for changing medical policy. - North Carolina Statutes

§ 108A‑54.3.  Proceduresfor changing medical policy.

The Department shall develop,amend, and adopt medical coverage policy in accordance with the following:

(1)        During thedevelopment of new medical coverage policy or amendment to existing medicalcoverage policy applicable to the North Carolina Health Choice Program forChildren, consult with and seek the advice of the Physician Advisory Group andother organizations the Secretary deems appropriate. The Secretary shall alsoconsult with and seek the advice of officials of the professional societies orassociations representing providers who are affected by the new medicalcoverage policy or amendments to existing medical coverage policy.

(2)        At least 45 daysprior to the adoption of new or amended medical coverage policy, the Departmentshall:

a.         Publish the proposednew or amended medical coverage policy on the Department's Web site;

b.         Notify all NorthCarolina Health Choice Program for Children providers of the proposed, new, oramended policy; and

c.         Upon request,provide persons copies of the proposed medical coverage policy.

(3)        During the 45‑dayperiod immediately following publication of the proposed new or amended medicalcoverage policy, accept oral and written comments on the proposed new or amendedpolicy.

(4)        If, following thecomment period, the proposed new or amended medical coverage policy ismodified, then the Department shall do all of the following, at least 15 daysprior to its adoption:

a.         Notify all NorthCarolina Health Choice Program for Children providers of the proposed policy.

b.         Upon request,provide persons notice of amendments to the proposed policy.

c.         Accept additionaloral or written comments during this 15‑day period.  (2009‑451, s. 10.32.)