H 4374 General Bill, By W.S. Houck, Askins, Breeland, R.S. Corning, 
L.L. Elliott, J.P. Harrelson, B.H. Harwell, J. Hines, Inabinett, Jennings, 
W.D. Keyserling, Kirsh, J.G. Mattos, Neilson, Richardson, I.K. Rudnick, 
J.J. Snow, Stuart, L.S. Whipper, Wilder, Wilkins and Witherspoon
 A Bill to permit an insured subscriber under an individual health insurance
 policy to choose his health care provider, require the company writing the
 policy to pay for the services either by direct payment to the provider or by
 reimbursing the subscriber, and provide that this Act also applies to health
 maintenance organizations, in which case the insured shall be required to pay
 the difference if the cost of the services provided exceeds the lowest bidder.

   12/08/93  House  Prefiled
   12/08/93  House  Referred to Committee on Labor, Commerce and Industry
   01/11/94  House  Introduced and read first time HJ-34
   01/11/94  House  Referred to Committee on Labor, Commerce and
                     Industry HJ-35

A BILL

TO PERMIT AN INSURED SUBSCRIBER UNDER AN INDIVIDUAL HEALTH INSURANCE POLICY TO CHOOSE HIS HEALTH CARE PROVIDER, REQUIRE THE COMPANY WRITING THE POLICY TO PAY FOR THE SERVICES EITHER BY DIRECT PAYMENT TO THE PROVIDER OR BY REIMBURSING THE SUBSCRIBER, AND PROVIDE THAT THIS ACT ALSO APPLIES TO HEALTH MAINTENANCE ORGANIZATIONS, IN WHICH CASE THE INSURED SHALL BE REQUIRED TO PAY THE DIFFERENCE IF THE COST OF THE SERVICES PROVIDED EXCEEDS THE LOWEST BIDDER.

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

SECTION 1. Notwithstanding any other provision of law, an insured subscriber under an individual health insurance policy in force in this State must be permitted to choose the health care provider, who must be in good standing with his or its respective licensing authority, for any services rendered to the insured, and the company writing the policy must pay for the services to the extent allowed or required by the insurance contract and by law, either by direct payment to the provider or by reimbursing the subscriber, as is applicable under the circumstances.

This section also applies to health maintenance organizations, and the insured in this situation shall be required to pay the difference if the cost of the services provided exceeds the lowest bidder.

SECTION 2. This act takes effect upon approval by the Governor.