North Carolina General Statutes
Article 3B - State Health Plan for Teachers and State Employees.
§ 135-48.10 - Confidentiality of information and medical records; provider contracts.

135-48.10. Confidentiality of information and medical records; provider contracts.
(a) Any information described in this section that is in the possession of the State Health Plan for Teachers and State Employees or its Claims Processor under the Plan or the Predecessor Plan shall be confidential and shall be exempt from the provisions of Chapter 132 of the General Statutes or any other provision requiring information and records held by State agencies to be made public or accessible to the public. This section shall apply to all information concerning individuals, including the fact of coverage or noncoverage, whether or not a claim has been filed, medical information, whether or not a claim has been paid, and any other information or materials concerning a plan participant, including Claim Payment Data and any documents or other materials derived from the Claim Payment Data. This information may, however, be released to the State Auditor or to the Attorney General in furtherance of their statutory duties and responsibilities, or to such persons or organizations as may be designated and approved by the State Treasurer. Any information so released shall remain confidential as stated above and any party obtaining such information shall assume the same level of responsibility for maintaining such confidentiality as that of the State Health Plan for Teachers and State Employees.
(b) The terms of a contract between the Plan and its third party administrator or between the Plan and its pharmacy benefit manager are a public record under Chapter 132 of the General Statutes. No provision of law, however, shall be construed to prevent or restrict the release of any information in a Plan contract to the State Treasurer, the State Auditor, the Attorney General, the Director of the State Budget, the Plan's Board of Trustees, and the Plan's Executive Administrator solely and exclusively for their use in the furtherance of their duties and responsibilities.
and after (1981, c. 355; 1981 (Reg. Sess., 1982), c. 1398, ss. 3, 4; 1983, c. 922, s. 21.10; 1985, c. 732, s. 38; 1985 (Reg. Sess., 1986), c. 1020, s. 20; 1998-1, s. 4(h); 2007-323, s. 28.22A(c); 2008-107, s. 10.13(m); 2008-168, s. 1(a), (c), (d); 2009-16, s. 5(f); 2009-83, s. 1; 2010-194, s. 18(a); 2011-85, ss. 1.9(a), 2.4(a), 2.10; 2011-326, s. 15(r); 2016-104, s. 2.)

Structure North Carolina General Statutes

North Carolina General Statutes

Chapter 135 - Retirement System for Teachers and State Employees; Social Security; State Health Plan for Teachers and State Employees

Article 3B - State Health Plan for Teachers and State Employees.

§ 135-48.1 - General definitions.

§ 135-48.2 - Undertaking.

§ 135-48.3 - Right to amend.

§ 135-48.4 - Conflict with federal law.

§ 135-48.5 - Health benefit trust funds created.

§ 135-48.8 - Statements of public interest.

§ 135-48.10 - Confidentiality of information and medical records; provider contracts.

§ 135-48.12 - Committee on Actuarial Valuation of Retired Employees' Health Benefits.

§ 135-48.15 - Whistle-blower protections related to the State Health Plan.

§ 135-48.16 - Fraud detection and audit programs.

§ 135-48.20 - Board of Trustees established.

§ 135-48.21 - Board officers, quorum, meetings.

§ 135-48.22 - Board powers and duties.

§ 135-48.23 - Executive Administrator.

§ 135-48.24 - Administrative review.

§ 135-48.25 - Rules.

§ 135-48.27 - Reports to the General Assembly; General Assembly access to information.

§ 135-48.28 - Auditing of the Plan.

§ 135-48.30 - Powers and duties of the State Treasurer.

§ 135-48.32 - Contracts to provide benefits.

§ 135-48.33 - Contracting provisions; large contract review by Board of Trustees and Attorney General, auditing, no cost plus contracts.

§ 135-48.34 - Contracts not subject to Article 3 of Chapter 143 of the General Statutes.

§ 135-48.35 - Contract disputes not contested case under the Administrative Procedure Act, Chapter 150B of the General Statutes.

§ 135-48.37 - Liability of third person; right of subrogation; right of first recovery.

§ 135-48.37A - Employing unit cooperation in collection of amounts owed to Plan.

§ 135-48.38 - Persons eligible for Medicare; optional participation in other Medicare products.

§ 135-48.39 - Operations during state of disaster or emergency.

§ 135-48.40 - Categories of eligibility.

§ 135-48.41 - Additional eligibility provisions.

§ 135-48.42 - Enrollment.

§ 135-48.43 - Effective dates of coverage.

§ 135-48.44 - Cessation of coverage.

§ 135-48.45 - Conversion.

§ 135-48.46 - Settlement agreements by employing units.

§ 135-48.47 - Participation in State Health Plan by local government employees and dependents.

§ 135-48.49 - IRC Sections 6055 and 6056 regulatory reporting.

§ 135-48.50 - Coverage mandates.

§ 135-48.51 - Coverage and operational mandates related to Chapter 58 of the General Statutes.

§ 135-48.52 - General limitations and exclusions.

§ 135-48.54 - Optional participation for charter schools operated by private nonprofit corporations or municipalities.

§ 135-48.56 - Education of covered active and retired employees.

§ 135-48.57 - Payments for county or city ambulance service.

§ 135-48.58 - Premiums for firefighters, rescue squad workers, and members of National Guard.