A bill

 

TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING SECTION 38-71-270 SO AS TO PROHIBIT DISCRIMINATION IN INSURANCE POLICIES REGARDING HIV STATUS AND PREVENTION AND TO DEFINE TERMS.

 

Be it enacted by the General Assembly of the State of South Carolina:

 

SECTION 1.  Article 1, Chapter 71, Title 38 of the S.C. Code is amended by adding:

 

    Section 38-71-270. (A) In determining whether to issue, cancel, or renew insurance coverage, an insurer may not:

       (1) use age, marital status, geographic area of residence, occupation, sex, sexual orientation, gender identity or expression, or any similar factor or combination of factors for the purpose of seeking to predict whether any individual may in the future develop AIDS or ARC; or

       (2) take into consideration an individual's use of HIV prevention treatment when taken pursuant to a valid prescriber's order.

    (B) In determining rates, premiums, dues, assessments, benefits covered, or expenses reimbursable, or in any other aspect of insurance marketing or coverage, an insurer may not:

       (1) use age, marital status, geographic area of residence, occupation, sex, sexual orientation, gender identity or expression, or any similar factor or combination of factors for the purpose of seeking to predict whether any individual may in the future develop AIDS or ARC; or

       (2) take into consideration an individual's use of HIV prevention treatment when taken pursuant to a valid prescriber's order.

    (C) No health or disability insurance policy or contract issued in this State may contain any exclusion, reduction, other limitation of coverage, deductibles, or coinsurance provisions related to HIV prevention treatment or the care and treatment of AIDS, ARC, HIV infection, or any illness or disease arising from these medical conditions, unless the provisions apply generally to all benefits under the policy or contract.

    (D) A named insured who tests positive for AIDS, ARC, or HIV may appeal to the director to review the testing procedures and results, and may present additional medical evidence, including the results of similar tests for exposure to the probable causative agent of AIDS that the named insured independently obtains, to rebut the positive test results. If the director determines that the result of the test of the proposed insured is not a true positive, the director must order the insurer from which the applicant sought coverage to disregard the positive test result. The director must, when necessary, request the advice of the Director of Public Health in making this determination.

    (E) An insurer may not impose cost sharing, require prior authorization, or impose any medically unnecessary restrictions or delays for the coverage of HIV prevention services, PEP, or any formulation of PrEP.

    (F) No health plan issued in this State or insurer offering health insurance in this State may use prescription information indicating the use of HIV prevention treatment to medically underwrite premiums for specific enrollees.

    (G) For purposes of this section:

       (1) "Director" means the Director of the Department of Insurance.

       (2) "HIV prevention services" means medical services to prevent HIV and AIDS, including baseline assessments, initial and follow-up appointments and services, medication for the management of side effects associated with PrEP and PEP, and medication self-management or adherence counseling.

       (3) "HIV prevention treatment" means medical treatment used to prevent HIV, including PrEP, PEP, and HIV prevention services.

       (4) "PEP" means post-exposure prophylaxis antiretroviral medication approved by the FDA used to prevent HIV in a person without HIV who may have been recently exposed to HIV.

       (5) "PrEP" means pre-exposure prophylaxis antiretroviral medication approved by the U.S. Food and Drug Administration used to prevent HIV in a person without HIV.

 

SECTION 2.  This act takes effect upon approval by the Governor.

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