Bill 1019

                    Current Status

Bill Number:                       1019
Type of Legislation:               General Bill GB
Introducing Body:                  Senate
Introduced Date:                   19960111
Primary Sponsor:                   McConnell 
All Sponsors:                      McConnell 
Drafted Document Number:           jic\5123ac.96
Companion Bill Number:             4381
Residing Body:                     Senate
Subject:                           Dermatological services, health
                                   insurance

Body    Date      Action Description                       Com     Leg Involved
______  ________  _______________________________________  _______ ____________

Senate  19960314  Minority report withdrawn
Senate  19960305  Committee report: majority               02 SBI
                  favorable, minority unfavorable
Senate  19960206  Committed to Committee                   02 SBI
Senate  19960206  Recalled from Committee                  13 SMA
Senate  19960111  Introduced, read first time,             13 SMA
                  referred to Committee

COMMITTEE REPORT

March 5, 1996

S. 1019

S. Printed 3/5/96--S.

Read the first time January 11, 1996.

To whom was referred a Bill (S. 1019), to amend the Code of Laws of South Carolina, 1976, by adding Section 38-71-215 so as to prohibit a health benefit policy from requiring as a condition for the coverage, etc., respectfully

That they have duly and carefully considered the same, and recommend that the same do pass:

Majority favorable. Minority unfavorable.

EDWARD E. SALEEBY LARRY A. MARTIN

For Majority. For Minority.

A BILL

TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 38-71-215 SO AS TO PROHIBIT A HEALTH BENEFIT POLICY FROM REQUIRING AS A CONDITION FOR THE COVERAGE OF DERMATOLOGICAL SERVICES THAT THE INSURED FIRST OBTAIN A REFERRAL FROM A PRIMARY CARE PHYSICIAN.

Whereas, it is the intent of the General Assembly to encourage health care cost containment while preserving the quality of care offered to citizens of this State. The General Assembly finds that there is an increasing number of health insurance benefit providers which require a referral from a primary care physician to a dermatologist as a condition of the payment of benefits to an insured patient. The General Assembly finds that such a requirement blocks unfairly a patient's choice of direct access to providers of health care services and may not be in the public interest. Now, therefore,

Be it enacted by the General Assembly of the State of South Carolina:

SECTION 1. The 1976 Code is amended by adding:

"Section 38-71-215. (A) No health policy which is issued, delivered, issued for delivery, or renewed in this State may require as a condition for the coverage of dermatological services that an enrollee, subscriber, or insured first obtain a referral from a primary care physician.

(B) As used in this section:

(1) `Dermatological services' means services ordinarily and customarily rendered by a physician specializing in the practice of dermatology;

(2) `Health benefit policy' means an individual or group plan, policy, or contract for health care services issued, delivered, issued for delivery, or renewed in this State by a health care corporation, health maintenance organization, accident and sickness insurer, fraternal benefit society, nonprofit hospital service corporation, nonprofit medical service corporation, or similar entity;

(3) `Primary care physician' means a physician as defined in the health benefit policy."

SECTION 2. This act takes effect July 1, 1996, and applies to health benefit policies as defined in Section 38-71-215 of the 1976 Code, as added by Section 1 of this act, that are issued, delivered, issued for delivery, or renewed in this State after July 1, 1996.