South Carolina General Assembly
110th Session, 1993-1994

Bill 26


                    Current Status
Introducing Body:               Senate
Bill Number:                    26
Ratification Number:            174
Act Number:                     129
Primary Sponsor:                Holland
Type of Legislation:            GB
Subject:                        Congenital orofacial
                                anomalies
Date Bill Passed both Bodies:   19930602
Computer Document Number:       S.26
Governor's Action:              S
Date of Governor's Action:      19930614
Introduced Date:                19930112
Date of Last Amendment:         19930601
Last History Body:              ------
Last History Date:              19930614
Last History Type:              Act No. 129
Scope of Legislation:           Statewide
All Sponsors:                   Holland
Type of Legislation:            General Bill

History

Bill   Body    Date          Action Description              CMN  Leg Involved
----   ------  ------------  ------------------------------  ---  ------------
26     ------  19930614      Act No. 129
26     ------  19930614      Signed by Governor
26     ------  19930610      Ratified R 174
26     Senate  19930602      Concurred in House amendment,
                             enrolled for ratification
26     House   19930602      Read third time, returned to
                             Senate with amendment
26     House   19930601      Amended, read second time
26     House   19930526      Committee Report: Favorable     26
                             with amendment
26     House   19930420      Introduced, read first time,    26
                             referred to Committee
26     Senate  19930415      Read third time, sent to House
26     Senate  19930414      Amended, read second time,
                             unanimous consent for third
                             reading on Thursday, April
                             15, 1993
26     Senate  19930414      Recalled from Committee         02
26     Senate  19930112      Introduced, read first time,    02
                             referred to Committee
View additional legislative information at the LPITS web site.


(Text matches printed bills. Document has been reformatted to meet World Wide Web specifications.)

(A129, R174, S26)

AN ACT TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 38-71-240, SO AS TO PROVIDE, AMONG OTHER THINGS, THAT ANY INDIVIDUAL OR GROUP ACCIDENT AND HEALTH INSURANCE POLICY WHICH PROVIDES DEPENDENT COVERAGE SHALL PROVIDE COVERAGE FOR THE MEDICALLY NECESSARY CARE AND TREATMENT OF CLEFT LIP AND PALATE AND ANY CONDITION OR ILLNESS WHICH IS RELATED TO OR DEVELOPED AS A RESULT OF A CLEFT LIP AND PALATE, THAT ANY INDIVIDUAL OR GROUP DENTAL POLICY WHICH PROVIDES DEPENDENT COVERAGE SHALL PROVIDE COVERAGE FOR TEETH CAPPING, PROSTHODONTICS, AND ORTHODONTICS NECESSARY FOR THE CARE AND TREATMENT OF CLEFT LIP AND PALATE, AND THAT THE PROVISIONS OF THIS SECTION DO NOT APPLY TO A POLICY WHICH PROVIDES DISABILITY OR INCOME PROTECTION COVERAGE, HOSPITAL CONFINEMENT INDEMNITY COVERAGE, ACCIDENT-ONLY COVERAGE, SPECIFIED DISEASE OR SPECIFIED ACCIDENT COVERAGE, LONG-TERM CARE COVERAGE, VISION-ONLY COVERAGE, OR COVERAGE ISSUED AS A SUPPLEMENT TO MEDICARE; AND TO PROVIDE THAT THIS ACT APPLIES TO ALL INSURANCE POLICIES DELIVERED, ISSUED, RENEWED, EXTENDED, OR MODIFIED BY ANY INSURER SIX MONTHS OR THEREAFTER FROM THE EFFECTIVE DATE OF THIS ACT.

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

Cleft lip and palate coverage; etc.

SECTION 1. Article 1, Chapter 71, Title 38 of the 1976 Code is amended by adding:

"Section 38-71-240. (A) As used in this section:

(1) `Cleft lip and palate' means a congenital cleft in the lip or palate, or both.

(2) `Medically necessary care and treatment' shall include, but not be limited to:

(a) oral and facial surgery, surgical management, and follow-up care made necessary because of a cleft lip and palate;

(b) prosthetic treatment such as obdurators, speech appliances, and feeding appliances;

(c) medically necessary orthodontic treatment and management;

(d) medically necessary prosthodontic treatment and management;

(e) otolaryngology treatment and management; (f) audiological assessment, treatment, and management performed by or under the supervision of a licensed doctor of medicine, including surgically implanted amplification devices; and

(g) medically necessary physical therapy assessment and treatment.

(B) (1) Any individual or group accident and health policy which provides dependent coverage shall provide coverage for the medically necessary care and treatment of cleft lip and palate and any condition or illness which is related to or developed as a result of a cleft lip and palate. Such a policy may contain the same copayment provisions for the coverage of cleft lip and palate as apply to other conditions or procedures covered by the policy.

(2) Any individual or group dental policy which provides dependent coverage shall provide coverage for teeth capping, prosthodontics, and orthodontics necessary for the care and treatment of cleft lip and palate. Such a policy may contain the same copayment provisions for the coverage of cleft lip and palate as apply to other conditions or procedures covered by the policy.

(C) If a person with a cleft lip and palate is covered by an accident and health policy described in subsection (B)(1) and is also covered by a dental policy described in subsection (B)(2), teeth capping, prosthodontics, and orthodontics shall be covered by the dental policy to the limit of coverage provided and any excess thereafter shall be provided by the individual or group accident and health policy.

(D) The provisions of this section do not apply to a policy which provides disability or income protection coverage, hospital confinement indemnity coverage, accident only coverage, specified disease or specified accident coverage, long-term care coverage, vision only coverage, or coverage issued as a supplement to Medicare."

Application of act

SECTION 2. This act applies to all policies delivered, issued, renewed, extended, or modified by any insurer six months or thereafter from the effective date of this act.

Time effective

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

Approved the 14th day of June, 1993.