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TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 38-71-42 SO AS TO REQUIRE HEALTH MAINTENANCE ORGANIZATIONS, INDIVIDUAL AND GROUP HEALTH INSURANCE POLICIES AND INSURANCE CONTRACTS ISSUED BEGINNING JANUARY 1, 2019, TO PROVIDE COVERAGE FOR CERTAIN TESTS FOR THE EARLY DETECTION OF CARDIOVASCULAR DISEASE; AND TO AMEND SECTION 1-11-710, AS AMENDED, RELATING TO THE PUBLIC EMPLOYEE BENEFIT AUTHORITY'S DUTY TO MAKE CERTAIN INSURANCE PLANS AVAILABLE, SO AS TO REQUIRE THE GROUP HEALTH PLAN COVER CERTAIN TESTS FOR THE EARLY DETECTION OF CARDIOVASCULAR DISEASE.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Article 1, Chapter 71, Title 38 of the 1976 Code is amended by adding:
"Section 38-71-42. (A) Beginning January 1, 2019, every health maintenance organization, individual and group health insurance policy, or insurance contract issued or renewed in this State must provide coverage for tests as set forth in subsection (B) for the early detection of cardiovascular disease for an insured who is:
(1) a male older than forty-five years of age and younger than seventy-six years of age or a female older than fifty-five years of age and younger than seventy-six years of age;
(2) diabetic; and
(3) has a risk of developing coronary heart disease, based on a score derived using the Framingham Heart Study coronary prediction algorithm, that is intermediate or higher.
(B) The minimum coverage that must be provided is up to two hundred dollars for the following noninvasive screening tests for atherosclerosis and abnormal artery structure and function every five years, performed by a national organization recognized by the director of the Department of Insurance:
(1) computed tomography (CT) scanning measuring coronary artery calcification; and
(2) ultrasonography measuring carotid intima-media thickness and plaque."
SECTION 2. Section 1-11-710 of the 1976 Code, as last amended by Act 278 of 2012, is further amended by adding an appropriately lettered subsection to read:
"( )(1) Beginning January 1, 2019, the plan approved by the board must provide coverage for tests set forth in Section 38-71-42(B) for the early detection of cardiovascular disease.
The plan must be for an employee, retiree, or dependent who meets the criteria set forth in Section 38-71-42(A) and the coverage must be provided in a manner consistent with Section 38-71-42(B)."
SECTION 3. This act takes effect upon approval by the Governor.
This web page was last updated on February 6, 2018 at 1:08 PM