§ 58-50-57. Offsets against provider reimbursement for workers' compensation payments forbidden.
§ 58‑50‑57. Offsets against provider reimbursement for workers' compensation paymentsforbidden.
(a) An insurer thatprovides a health benefit plan as defined in G.S. 58‑3‑167 shallnot offset or reverse a health plan payment against a provider reimbursementfor other medical charges unless the health plan payment was for a specificmedical charge for which the employee, employer, or carrier is liable orresponsible according to a final adjudication of the claim under the Workers'Compensation Act, Article 1 of Chapter 97 of the General Statutes or an orderof the North Carolina Industrial Commission approving a settlement agreemententered into under that Article.
(b) No contract betweenan insurer that provides a health benefit plan as defined in G.S. 58‑3‑167and a medical provider shall contain a provision that authorizes the insurer tooffset or reverse a health plan payment against a provider reimbursement forother medical charges unless the health plan payment was for a specific medicalcharge for which the employee, employer, or carrier is liable or responsibleaccording to a final adjudication of the claim under the Workers' CompensationAct, Article 1 of Chapter 97 of the General Statutes or an order of the NorthCarolina Industrial Commission approving a settlement agreement entered intounder that Article. (2001‑216, s. 5; 2001‑487, s. 102(b).)