§ 58-3-176. Treatment discussions not limited. - North Carolina Statutes

§58‑3‑176.  Treatment discussions not limited.

(a)        An insurer shallnot limit either of the following:

(1)        The participatingplan provider's ability to discuss with an enrollee the clinical treatmentoptions medically available, the risks associated with the treatments, or arecommended course of treatment.

(2)        The participatingplan provider's professional obligations to patients as specified under theprovider's professional license.

(b)        Nothing in thissection shall be construed to expand or revise the scope of benefits covered bya health benefit plan.

(c)        As used in thissection:

(1)        "Health benefitplan" means any of the following if written by an insurer: an accident andhealth insurance policy or certificate; a nonprofit hospital or medical servicecorporation contract; a health maintenance organization subscriber contract; ora plan provided by a multiple employer welfare arrangement. "Healthbenefit plan" does not mean any plan implemented or administered throughthe Department of Health and Human Services or its representatives."Health benefit plan" also does not mean any of the following kindsof insurance:

a.         Accident.

b.         Credit.

c.         Disability income.

d.         Long‑term ornursing home care.

e.         Medicare supplement.

f.          Specified disease.

g.         Dental or vision.

h.         Coverage issued as asupplement to liability insurance.

i.          Workers'compensation.

j.          Medical paymentsunder automobile or homeowners insurance.

k.         Hospital income orindemnity.

l.          Insurance underwhich benefits are payable with or without regard to fault and that isstatutorily required to be contained in any liability policy or equivalent self‑insurance.

(2)        "Insurer"means an entity that writes a health benefit plan and that is an insurancecompany subject to this Chapter, a service corporation under Article 65 of thisChapter, a health maintenance organization under Article 67 of this Chapter, ora multiple employer welfare arrangement under Article 49 of this Chapter. (1997‑443,s. 11A.122; 1997‑474, s. 1.)