Current Status Bill Number:
3181Type of Legislation: General Bill GBIntroducing Body: HouseIntroduced Date: 19970114Primary Sponsor: SeithelAll Sponsors: SeithelDrafted Document Number: gjk\23161ac.97Residing Body: HouseCurrent Committee: Labor, Commerce and Industry Committee 26 HLCISubject: Health benefit insurance plans, obstetrical and gynecological services, medical
Body Date Action Description Com Leg Involved ______ ________ _______________________________________ _______ ____________ House 19970114 Introduced, read first time, 26 HLCI referred to Committee House 19970108 Prefiled, referred to Committee 26 HLCIView additional legislative information at the LPITS web site.
TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 38-33-325 SO AS TO REQUIRE HEALTH BENEFIT PLANS TO ALLOW FEMALE PARTICIPANTS DIRECT ACCESS, WITHOUT REFERRAL, TO OBSTETRICAL AND GYNECOLOGICAL HEALTH CARE SERVICES WITHIN THE PLAN BENEFITS AND TO REQUIRE THE PLAN TO INFORM FEMALE PARTICIPANTS IN WRITING OF THIS REQUIREMENT.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. The 1976 Code is amended by adding:
"Section 38-33-325. (A) A health benefit plan shall allow a female plan participant or beneficiary thirteen years of age or older direct access within the health benefit plan, without prior referral, to the health care services of an obstetrician-gynecologist participating in the health benefit plan, within the benefits provided under that health benefit plan pertaining to obstetrician-gynecologist services.
(B) A health benefit plan shall inform female participants and beneficiaries in writing of the provisions of this subsection (A). The information must be provided in benefit handbooks and materials and enrollment materials.
(C) For purposes of this section:
(1) 'Health benefit plan' means a health maintenance organization subscriber contract or a preferred provider, exclusive provider, or other managed care arrangement offered under a health benefit plan;
(2) 'Health care services' means the full scope of medically necessary services provided by the participating obstetrician-gynecologist in the care of or related to the female reproductive system and breasts and in performing annual screening, counseling, and immunization for disorders and diseases in accordance with the most current published recommendations of the American College of Obstetricians and Gynecologists and includes services provided by nurse practitioners, physician's assistants, and certified midwives in collaboration with the obstetrician-gynecologist in the care of the participant or beneficiary.
(3) 'Benefits' are medical services or other items to which an individual is entitled under the terms of a contract with a health benefit plan, as approved by the Department of Insurance."
SECTION 2. This act takes effect July 1, 1997, and applies to health benefit plans issued, renewed, or amended after June 30, 1997. For purposes of this act, renewal of a health benefit plan is presumed to occur on each anniversary of the date when coverage was first effective on a person covered by the plan.