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Current Status Bill Number:View additional legislative information at the LPITS web site.66 Type of Legislation:General Bill GB Introducing Body:Senate Introduced Date:19990112 Primary Sponsor:Hayes All Sponsors:Hayes, Leventis, Rankin Drafted Document Number:l:\council\bills\nbd\11001jm99.doc Residing Body:Senate Current Committee:Banking and Insurance Committee 02 SBI Subject:Mental illness, health insurance plans to provide coverage for treatment of; Medical, Mental Health History Body Date Action Description Com Leg Involved ______ ________ ______________________________________ _______ ____________ Senate 19990112 Introduced, read first time, 02 SBI referred to Committee Senate 19981118 Prefiled, referred to Committee 02 SBI Versions of This Bill
TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 38-71-280 SO AS TO PROVIDE THAT INSURANCE BENEFITS FOR THE TREATMENT OF MENTAL ILLNESS ARE SUBJECT TO THE SAME DEDUCTIBLES, DURATIONAL LIMITS, AND COINSURANCE FACTORS AS ARE INSURANCE BENEFITS FOR PHYSICAL ILLNESS GENERALLY, TO STIPULATE THE PROVIDERS WHO ARE AUTHORIZED TO PROVIDE CARE AND TREATMENT FOR MENTAL ILLNESS FOR PURPOSES OF THE ABOVE PROVISION, TO PROVIDE THAT SUCH BENEFITS ARE SUBJECT TO MANAGED INDIVIDUALIZED CARE COMPONENTS AND ARE SUBJECT TO A COINSURANCE RATE UNDER CERTAIN CONDITIONS, AND TO PROVIDE FOR RELATED MATTERS.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. The 1976 Code is amended by adding:
"Section 38-71-280. (A) Except as otherwise provided in this section, benefits for the treatment of mental illness are subject to the same deductibles, durational limits, and coinsurance factors as are benefits for physical illness generally.
(B) The following necessary services for the care and treatment of mental illness are covered under this section: allowable institutional and professional charges for inpatient psychiatric care, outpatient psychotherapy, intensive outpatient crisis management, partial hospitalization treatment, and residential care and treatment. The benefits provided by this section are separate and apart from those provided otherwise by the provisions of this chapter.
(C) The following providers are authorized to provide necessary care and treatment for mental illness under this section: licensed psychiatrists and doctors of psychology licensed or certified in their states of practice, psychiatric nurses or social workers or psychological associates with a master's degree in psychology under the direct employment and supervision of a licensed psychiatrist or licensed or certified doctor of psychology, licensed psychiatric hospitals and licensed general hospitals providing psychiatric treatment programs and certified residential treatment facilities, community mental health centers, and partial hospitalization facilities.
(D) Benefits provided under this section are subject to a managed individualized care component consisting of:
(1) inpatient utilization review through pre-admission and length-of-stay certification for scheduled inpatient admissions and length-of-stay reviews for unscheduled inpatient admissions, and
(2) a network of qualified, available providers of inpatient and outpatient psychiatric treatment and psychotherapy.
Where qualified preferred providers of inpatient and outpatient care are reasonably available, use of providers outside of the preferred network is subject to a twenty percent coinsurance rate up to five thousand dollars per fiscal year to be assessed against each covered individual in addition to the general coinsurance percentage and maximum fiscal year amount."
SECTION 2. This act takes effect upon approval by the Governor.
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