H 4236 General Bill, By H.H. Keyserling, K.T. Burch, A.W. Byrd, Cork, Glover, 
J.L. Harris, K.G. Kempe, S.G. Manly, Neilson, Meacham, J.S. Shissias, 
L.S. Taylor, C.Y. Waites, C.C. Wells, L.S. Whipper, J.M. White, S.S. Wofford and 
Young-Brickell
 A Bill to amend the Code of Laws of South Carolina, 1976, by adding Section
 38-71-145 so as to require an insurer to include coverage for mammograms and
 pap smears in all health and accident or health insurance policies issued
 after December 31, 1992, and to provide definitions.

   01/22/92  House  Introduced and read first time HJ-6
   01/22/92  House  Referred to Committee on Labor, Commerce and
                     Industry HJ-6

A BILL

TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 38-71-145 SO AS TO REQUIRE AN INSURER TO INCLUDE COVERAGE FOR MAMMOGRAMS AND PAP SMEARS IN ALL HEALTH AND ACCIDENT OR HEALTH INSURANCE POLICIES ISSUED AFTER DECEMBER 31, 1992, AND TO PROVIDE DEFINITIONS.

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

SECTION 1. The 1976 Code is amended by adding:

"Section 38-71-145. (A) As used in this section:

(1) `Mammogram' means a radiological examination of the breast for purposes of detecting breast cancer when performed as a result of a physician referral or by a health testing service which utilizes radiological equipment approved by the Department of Health and Environmental Control, which examination may be made with the following minimum frequency:

(a) once as a base-line mammogram for a female who is at least thirty-five but less than forty years of age;

(b) once every two years for a female who is at least forty but less than fifty years of age;

(c) once every year for a female who is at least fifty years of age; and

(d) when recommended by a physician for a female, without regard to age, where needed for diagnostic purposes or when she, her mother, or her sister has had a prior history of breast cancer.

(2) `Pap smear' or `Papanicolaou smear' means an examination of the tissues of the cervix of the uterus for the purpose of detecting cancer when performed upon the recommendation of a physician, which examination may be made once a year or more often if recommended by a physician.

(3) `Policy' means any benefit plan, contract, or policy except a disability income policy, specified disease policy, or hospital indemnity policy.

(B) An insurer authorized to issue an individual or group accident and health or health insurance policy in this State shall include coverage for mammograms and Pap smears in the policy.

(C) The coverage required to be offered under subsection (B) may not contain any exclusions, reductions, or other limitations as to coverages, deductibles, or coinsurance provisions which apply to that coverage unless these provisions apply generally to other similar benefits provided or paid for under the accident and health or health insurance policy.

(D) Nothing in this section may be construed to prohibit the issuance of an accident and health or health insurance policy which provides benefits greater than those required to be offered by subsections (B) and (C) or more favorable to the insured than those required to be offered by subsections (B) and (C).

(E) This section applies to individual and group accident and health and health insurance policies issued by a fraternal benefit society, a nonprofit hospital service corporation, a nonprofit medical service corporation, a health care plan, a health maintenance organization, or any similar entity."

SECTION 2. Section 38-71-145 of the 1976 Code, added in Section 1 of this act, applies to accident and health and health insurance policies issued after December 31, 1992.

SECTION 3. This act takes effect upon approval by the Governor.