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4441Ratification Number: 423Act Number: 348Type of Legislation: General Bill GBIntroducing Body: HouseIntroduced Date: 20000113Primary Sponsor: CatoAll Sponsors: Cato, Cooper and TrippDrafted Document Number: l:\council\bills\nbd\11610ac00.docCompanion Bill Number: 1026Date Bill Passed both Bodies: 20000601Date of Last Amendment: 20000601Governor's Action: SDate of Governor's Action: 20000614Subject: Insurance, Medical; health maintenance organizations; diabetes mellitus, coverage provisions; PharmaciesHistory Body Date Action Description Com Leg Involved ______ ________ ______________________________________ _______ ____________ ------ 20000628 Act No. A348 ------ 20000614 Signed by Governor ------ 20000608 Ratified R423 House 20000601 Concurred in Senate amendment, enrolled for ratification Senate 20000601 Amended, read third time, returned to House with amendment Senate 20000531 Amended, read second time Senate 20000525 Recalled from Committee, 02 SBI placed on the Calendar Senate 20000229 Introduced, read first time, 02 SBI referred to Committee House 20000224 Read third time, sent to Senate House 20000223 Read second time House 20000222 Debate adjourned until Wednesday, 20000223 House 20000216 Committee report: Favorable 26 HLCI ------ 20000117 Scrivener's error corrected House 20000113 Introduced, read first time, 26 HLCI referred to Committee Versions of This Bill Revised on January 17, 2000 - Word format Revised on February 16, 2000 - Word format Revised on May 25, 2000 - Word format Revised on May 31, 2000 - Word format Revised on June 1, 2000 - Word format
(A348, R423, H4441)
AN ACT TO AMEND SECTION 38-71-46, AS AMENDED, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO DIABETES MELLITUS COVERAGE BY HEALTH MAINTENANCE ORGANIZATION AND HEALTH INSURANCE POLICIES, SO AS TO REQUIRE THESE POLICIES TO ALSO COVER FEDERALLY APPROVED MEDICATION FOR DIABETES TREATMENT, TO PROVIDE THAT SUCH COVERAGE MAY BE PROVIDED ACCORDING TO FORMULARY OR BY USING NETWORK PROVIDERS, AND TO PROVIDE THAT COVERAGE MAY NOT BE DENIED UNLESS THE PRESCRIBING HEALTH CARE PROFESSIONAL DEMONSTRATES A PERSISTENT PATTERN OF FAILURE TO ADHERE TO MINIMUM STANDARDS OF CARE.
Be it enacted by the General Assembly of the State of South Carolina:
Required coverage for diabetes medication
SECTION 1. Section 38-71-46(A) of the 1976 Code, as amended by an act of 2000 bearing ratification number 245, is further amended to read:
"(A) On or after January 1, 2000, every health maintenance organization, individual and group health insurance policy, or contract issued or renewed in this State must provide coverage for the equipment, supplies, Food and Drug Administration-approved medication indicated for the treatment of diabetes, and outpatient self-management training and education for the treatment of people with diabetes mellitus, if medically necessary, and prescribed by a health care professional who is legally authorized to prescribe such items and who demonstrates adherence to minimum standards of care for diabetes mellitus as adopted and published by the Diabetes Initiative of South Carolina. This subsection does not prohibit a health maintenance organization or an individual or a group health insurance policy from providing coverage for medication according to formulary or using network providers. Coverage must not be denied unless the health care professional demonstrates a persistent pattern of failure to adhere to the minimal standards of care and unless the health maintenance organization or insurer has first provided written notice to the health care professional that coverage will be denied if the health care professional fails to adhere to the minimal standards of care."
SECTION 2. The provisions added by this act take effect upon approval by the Governor.
Ratified the 8th day of June, 2000.
Approved the 14th day of June, 2000.
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