CorVel helps reduce workers’ compensation costs through immediate intervention, claims management, medical treatment plans, return to work programs, medical bill review, preferred provider savings and patient management. Our cost containment solutions are based on a simple formula that combines industry leading bill review, case management expertise and a national PPO built for the casualty market. Each innovation offers North Carolina employers improved return to work outcomes and industry leading savings.
CorVel specializes in applying advanced communication and information technology to improve disability management for North Carolina employers. Our proprietary solutions can be tailored to your specific state risk management program.
As a service to our clients, CorVel is providing links to information related to the COVID-19 pandemic provided by the states.
COVID-19 Related Policies
HB 622 – Provide WC for PTSD in First Responders.
This measure relates to workers’ compensation for PTSD.
This measure stipulates that post-traumatic stress disorder is included as a compensable occupational disease through workers’ compensation for first responders to include volunteer firefighters.
Most Recent Update: During the May 15 hearing, no action was taken. This measure awaits further consideration in committee.
North Carolina Regulatory Updates 11/03/2023
SB 452 – Nc Department of Insurance Omnibus .-Ab
Issues: Workers’ Compensation: Any Proposal
Summary For 10/03/2023
This measure states that the drug for cancer treatment may be found in The Micromedex DrugDex System. This measure states that the association must be responsible for claims between $50 and $500,000. This measure states that the association is not responsible for covering a claimant’s loss over $500,000.
This measure states that if the commissioner determines that the continued operation of an insurer subject to this article is bad for insurance policyholders, creditors, or the general public then the commissioner may require the insurer to elect between securing a deposit held by the commissioner or a bond with respect to any contract or agreement entered into by the insurer. If an insurer subject to this Article is hazardous to the insurer’s policyholders, creditors, or the general public. This measure states that all records or data of the insurer held by an affiliate remain the insurer’s property and are subject to the insurer’s control. This measure states that premiums or other funds belonging to the insurer held by an affiliate are the exclusive property of the insurer and are subject to the control of the insurer.
This measure states that large deductible policies must be managed according to their terms. This measure requires large deductible policies that have multiple covered claims to be turned over to the Association for handling and administration or to the foreign guaranty association in the state where the claim is pending for handling and administration.
This measure requires the Association or a foreign guaranty association to collect reimbursements owed for deductible claims and must take all commercially reasonable actions to collect those reimbursements. This measure states that an insured has 60 days after the billing to make a payment and if the insured fails to make a payment all commercially reasonable actions to collect those reimbursements that are owed.
This measure allows the Association or a foreign guaranty association to use collateral when available to fund or reimburse deductible claims or other secured obligations.
This measure states that no small employer carrier, insurer, subsidiary of an insurer, or controlled individual of an insurance holding company must provide stop loss, catastrophic, or reinsurance coverage to small employers who employ fewer than five eligible employees. An insurer must not issue a stop loss health insurance policy to any person, firm, corporation, partnership or association defined as a small employer that provide coverage of health expenses payable to an individual. This takes effect October 1, 2023. This measure takes effect immediately when it becomes law.
Most Recent Update:
- 10/02/2023 – Became law without signature
North Carolina Regulatory Updates 9/1/2021
SB 105 – 2021 Appropriations Act
Issues: Workers’ Compensation (General); Medicaid Managed Care; Utilization Review and Appeals; Behavioral Health Coverage
Summary for Telehealth Requirements for 08/12/2021 Version
This measure provides the requirements that apply to all health benefit plans offered in this State regarding telehealth.
This measure provides that all of the following must apply to all health benefit plans offered in this State:
(1) A health benefit plan may not exclude from coverage a health care service or procedure delivered by a health care professional to an insured through telehealth solely because the health care service or procedure is not provided through an in-person, face-to-face consultation. This includes reimbursement for
patient monitoring using telehealth.
(2) A health benefit plan must reimburse for provider-to-provider consultations that are conducted using telehealth if the health benefit plan would provide reimbursement for that consult had it taken place in person, face-to-face.
(3) A health benefit plan may require a deductible, a copayment, or coinsurance for a covered health care service or procedure delivered by a preferred or contracted health professional to an insured through telehealth. The amount of the deductible, copayment, or coinsurance may not exceed the amount of the deductible, copayment, or coinsurance required had the covered health care service been provided in person, face-to-face.
(4) No health benefit plan may require prior authorization for the delivery of health care services through telehealth if prior authorization is not required had the health care service taken place in person, face-to-face.
(5) No health benefit plan may put limits on the originating site or the distant site for the delivery of health care through telehealth.
(6) Telehealth cannot be used for any health care services related to an abortion, including a medication abortion, except in the case of a medical emergency. (Pg. 302-303)
Summary for Workers’ Comp for 08/12/2021 Version
This measure provides that trauma-related injuries must be included when determining eligibility of a first responder for compensation benefits. This measure provides that trauma-related injuries must be included when determining eligibility of a first responder for compensation benefits. Posttraumatic stress disorder, as described in the Diagnostic and Statistical Manual of Mental Disorders, Current Edition, published by the American Psychiatric Association, suffered by a first responder is a compensable occupational disease if the first responder is examined and subsequently diagnosed with such disorder by a health care provider who establishes within a reasonable degree of medical certainty that the posttraumatic stress disorder is caused by activities of employment as a first responder. (Pg. 303)
Summary for Prepaid Health Plans for 08/12/2021
This provision has been removed by the August 9 amendments. See below for previous language.
This measure establishes the services covered by Prepaid Health Plans, which include:
•Inpatient behavioral health services
•Outpatient behavioral health emergency room services
•Outpatient behavioral health services provided by direct-enrolled providers
•Mobile crisis management services
•Facility-based crisis services for children and adolescents
•Professional treatment services in a facility-based crisis program
•Outpatient opioid treatment services
•Ambulators detoxification services
•Nonhospital medical detoxification services
•Medical supervised or alcohol and drug abuse treatment center detoxification crisis stabilization
•Research-based intensive behavioral health treatment
•Diagnostic assessment services
•Early and periodic screening, diagnosis, and treatment services
•Behavioral health urgent care services. (Pg. 137)
Most Recent Update:
8/17/2021 The Senate refused to concur on the House amendments. This measure has been referred to a conference committee, which will consist of members of each chamber. Conference committees are closed to the public, though their report will be released once a compromise on this measure has been reached.
SB 516 – Extended Group Coverage/Employee Deceased
Issues: Workers’ Compensation (General)
This bill allows the continuation of a group health insurance policy of a widowed spouse or surviving dependent for 36 months after the date the covered employee has decreased. This measure is applicable to a widowed spouse or surviving dependent. This bill extends the survivor benefit for descendants of deceased beneficiaries of a group health insurance plan to 36 months, in place of the previous 18 months. This bill is effective October 1, 2021
Most Recent Update:
4/5/2021 This measure has been introduced and referred to the Senate Rules Committee, chaired by Senator Rabon (R). This measure is eligible to be scheduled for a hearing at the discretion of the chair.
North Carolina Services
- Workers’ compensation claims administration
- Medical bill review in compliance with state requirements
- Local PPO development and management
- Case management services
North Carolina Resources
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