GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 1999

H	1 

HOUSE BILL 1207

Short Title:  Eligibility for State Health Benefits. 	(Public)

─────────────────────────────────────── 
Sponsors: Representatives Culpepper; Mosley and Hurley.

─────────────────────────────────────── 
Referred to:  Judiciary IV.

─────────────────────────────────────── 

April 15, 1999

A BILL TO BE ENTITLED
AN ACT TO ALLOW INDIVIDUALS EXCLUDED FROM MEMBERSHIP IN THE TEACHERS' AND STATE EMPLOYEES' COMPREHENSIVE MAJOR MEDICAL PLAN FOR FILING FRAUDULENT CLAIMS TO BE REINSTATED IN THE PLAN.
The General Assembly of North Carolina enacts:
Section 1.  G.S. 135-40.2(h) reads as rewritten:
"(h)	No person shall be eligible for coverage as an employee or retired employee or as a dependent of an employee or retired employee upon a finding by the Executive Administrator or Board of Trustees or by a court of competent jurisdiction that the employee or dependent knowingly and willfully made or caused to be made a false statement or false representation of a material fact in a claim for reimbursement of medical services under the Plan.  Persons subject to this subsection shall have a cessation of coverage for a period of five years and are eligible for benefits after the five-year period upon a full and complete restitution to the Plan for all fraudulent claim amounts."
Section 2.  G.S. 135-40.11(a)(6) reads as rewritten:
"(6)	The last day of the month in which a covered individual is found to have knowingly and willfully made or caused to be made a false statement or false representation of a material fact in a claim for reimbursement of medical services under the Plan.  Persons subject to this subdivision shall have a cessation of coverage for a period of five years and are eligible for benefits after the five-year period upon a full and complete restitution to the Plan for all fraudulent claim amounts."
Section 3.  This act is effective when it becomes law.