§ 58-50-270. Definitions. - North Carolina Statutes

Part 7. Contracts Between HealthBenefit Plans and Health Care Providers.

§ 58‑50‑270. Definitions.

Unless the context clearlyrequires otherwise, the following definitions apply in this Part.

(1)        "Amendment"– Any change to the terms of a contract, including terms incorporated byreference, that modifies fee schedules. A change required by federal or Statelaw, rule, regulation, administrative hearing, or court order is not anamendment.

(2)        "Contract"– An agreement between an insurer and a health care provider for the provisionof health care services by the provider on a preferred or in‑networkbasis.

(3)        "Health benefitplan" – A policy, certificate, contract, or plan as defined in G.S. 58‑3‑167.

(3a)      "Health careprovider" – An individual who is licensed, certified, or otherwiseauthorized under Chapter 90 or Chapter 90B of the General Statutes or under thelaws of another state to provide health care services in the ordinary course ofbusiness or practice of a profession or in an approved education or trainingprogram and a facility that is licensed under Chapter 131E or Chapter 122C ofthe General Statutes or is owned or operated by the State of North Carolina inwhich health care services are provided to patients.

(4)        "Insurer"– An entity as defined in G.S. 58‑3‑227(a)(4).  (2009‑352, s. 1; 2009‑487,s. 2(a).)