H 3162 General Bill, By J. Brown
 A BILL TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION
 38-71-146 SO AS TO PROVIDE THAT EVERY HEALTH MAINTENANCE ORGANIZATION,
 INDIVIDUAL, AND GROUP HEALTH INSURANCE POLICY OR CONTRACT ISSUED OR RENEWED IN
 SOUTH CAROLINA SHALL PROVIDE COVERAGE FOR THE EQUIPMENT, SUPPLIES, AND
 OUTPATIENT SELF-MANAGEMENT TRAINING AND EDUCATION FOR THE TREATMENT OF PEOPLE
 WITH DIABETES MELLITUS, AND PROVIDE FOR RELATED MATTERS.

   01/06/99  House  Prefiled
   01/06/99  House  Referred to Committee on Labor, Commerce and Industry
   01/12/99  House  Introduced and read first time HJ-61
   01/12/99  House  Referred to Committee on Labor, Commerce and
                     Industry HJ-61

TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 38-71-146 SO AS TO PROVIDE THAT EVERY HEALTH MAINTENANCE ORGANIZATION, INDIVIDUAL, AND GROUP HEALTH INSURANCE POLICY OR CONTRACT ISSUED OR RENEWED IN SOUTH CAROLINA SHALL PROVIDE COVERAGE FOR THE EQUIPMENT, SUPPLIES, AND OUTPATIENT SELF-MANAGEMENT TRAINING AND EDUCATION FOR THE TREATMENT OF PEOPLE WITH DIABETES MELLITUS, AND PROVIDE FOR RELATED MATTERS.

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

SECTION 1. The 1976 Code is amended by adding:

"Section 38-71-146. (A) Every health maintenance organization, individual, and group health insurance policy or contract issued or renewed in the State shall provide coverage for the equipment, supplies, and outpatient self-management training and education for the treatment of people with diabetes mellitus, if medically necessary, and prescribed by a health care professional legally authorized to prescribe such items by law who demonstrates adherence to minimal standards of care for diabetes mellitus as adopted and published by the Diabetes Initiative of South Carolina.

(B) Services and payment for diabetes education programs shall conform to regulations of the Health Care Financing Administration, United States Department of Health and Human Services, pursuant to Section 4105 of the Balanced Budget Act of 1997. Diabetes outpatient self-management training and education shall be provided by a registered or licensed health care professional with certification in diabetes by the National Certification Board of Diabetes Educators, or other accredited program approved by the Diabetes Initiative of South Carolina, or by the Diabetes Control Program of the South Carolina Department of Health and Environmental Control in order to meet the needs of rural communities wherein certified health care professionals providing this service are not available.

(C) Nothing contained in this section may be construed to affect in any way the ability of a managed care plan to credential or re-credential a provider.

(D)(1) The benefits provided in this section are subject to the same annual deductibles or co-insurance established for all other covered benefits within a given policy or contract of insurance.

(2) Private third party payors may not reduce or eliminate coverage due to the requirements of this section."

SECTION 2. This act takes effect upon approval by the Governor and applies to policies or contracts of insurance issued or renewed on or after July 1, 1999.