Current Status Bill Number:3076 Type of Legislation:General Bill GB Introducing Body:House Introduced Date:19970114 Primary Sponsor:Moody-Lawrence All Sponsors:Moody-Lawrence and Stuart Drafted Document Number:gjk\23124ac.97 Residing Body:House Current Committee:Labor, Commerce and Industry Committee 26 HLCI Subject:Medical and health insurance policies, mammograms, pap smears, prostrate cancer exams
Body Date Action Description Com Leg Involved
______ ________ _______________________________________ _______ ____________
House 19970114 Introduced, read first time, 26 HLCI
referred to Committee
House 19961218 Prefiled, referred to Committee 26 HLCI
View additional legislative information at the LPITS web site.
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, PAP SMEARS, PROSTATE CANCER EXAMINATIONS, SCREENING, AND DIAGNOSTIC LABORATORY WORK IN ALL HEALTH AND ACCIDENT OR HEALTH INSURANCE POLICIES ISSUED AFTER DECEMBER 31, 1997.
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) An insurer authorized to issue an individual or group accident and health or health insurance policy in this State shall include coverage in the policy for:
(1) mammograms and pap smears;
(2) prostate cancer examinations, screenings, and laboratory work for diagnostic purposes in the policy. Diagnostic procedures that must be included in the coverage are ultrasonography and prostate specific antigen screening and at a minimum must be provided for men fifty years of age or older; other diagnostic procedures may be included in the coverage.
(B) The coverage required to be offered under subsection (A) 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.
(C) 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 (A) and (B) or more favorable to the insured than those required to be offered by subsections (A) and (B).
(D) 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.
(E) For purposes of 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' 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 a benefit plan, contract, or policy except a disability income policy, specified disease policy, or hospital indemnity policy."
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, 1997.
SECTION 3. This act takes effect upon approval by the Governor.