§ 97-88.3. Penalty for health care providers. - North Carolina Statutes

§97‑88.3.  Penalty for health care providers.

(a)        In addition to anyliability under G.S. 97‑88.2, any health care provider who willfully orintentionally undertakes the following acts is subject to an administrativepenalty, assessed by the Commission, not to exceed ten thousand dollars($10,000):

(1)        Submitting chargesfor health care that was not furnished;

(2)        Fraudulentlyadministering, providing, and attempting to collect for inappropriate orunnecessary treatment or services; or

(3)        Violating the provisionsof Article 28 of Chapter 90 of the General Statutes.

A penalty assessed by theCommission for a violation of subdivision (3) of this subsection is in additionto penalties assessed under G.S. 90‑407.

(b)        In addition to anyliability under G.S. 97‑88.2, any health care provider who willfully orintentionally undertakes the following acts is subject to an administrativepenalty, assessed by the Commission, not to exceed one thousand dollars($1,000):

(1)        Failing or refusingto timely file required reports or records;

(2)        Making unnecessaryreferrals; and

(3)        Knowingly violatingthis Article or rules promulgated hereunder, including treatment guidelines,with intention to deceive or to gain improper advantage of a patient, employee,insurer, or the Commission.

(c)        A health careprovider who knowingly charges or otherwise holds an employee financiallyresponsible for the cost of any services provided for a compensable injuryunder this Article is guilty of a Class 1 misdemeanor.

(d)        Any person,including, but not limited to, an employer, an insurer, and an employee of aninsurer, who in good faith comes forward with information under this section,shall not be liable in a civil action.

(e)        Informationrelating to possible violations under this section shall be reported to theCommission which shall refer the same to the appropriate licensing orregulatory board or authority for the health care provider involved.

(f)         A hospital thatrelies in good faith on a written order of a physician in performing healthcare services shall not be subject to an administrative penalty in violation ofthis section. (1993 (Reg. Sess., 1994), c. 679, s. 7.2.)