A bill

 

TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ENACTING THE "PROTECTING CHILDREN FROM CANCER-CAUSING RADIATION ACT" BY ADDING SECTION 44-7-387 SO AS TO REQUIRE HEALTHCARE PROVIDERS TREATING PEDIATRIC PATIENTS TO TAKE CERTAIN STEPS BEFORE RECOMMENDING X-RAY IMAGING FOR DIAGNOSTIC PURPOSES; TO REQUIRE HEALTH INSURANCE PROVIDERS TO COVER PEDIATRIC DIAGNOSTIC IMAGING AS RECOMMENDED BY HEALTHCARE PROVIDERS; AND FOR OTHER PURPOSES.

 

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

 

SECTION 1.  This act may be cited as the "Protecting Children from Cancer-Causing Radiation Act."

 

SECTION 2.  Article 3, Chapter 7, Title 44 of the S.C. Code is amended by adding:

 

    Section 44-7-387.  (A) A hospital or other healthcare facility operating in this State must ensure that healthcare providers treating pediatric patients take special care in reducing radiation exposure to pediatric patients by implementing protocols and procedures that require healthcare providers to:

       (1) determine if the imaging is needed to answer a clinical question;

       (2) consider alternate exams that use less or no radiation exposure, such as ultrasound or MRI, if appropriate;

       (3) check the patient's medical imaging history to avoid duplicate exams; and

       (4) discuss the rationale for the recommended imaging with the patient's parent or legal guardian to ensure a clear understanding of benefits and risks.

    (B) The decision regarding the type of diagnostic imaging to use on a pediatric patient should be in the complete discretion of the healthcare provider in consultation with the patient's parent or legal guardian, not the insurance provider.

    (C)(1) Every individual and group health insurance and health maintenance organization policy issued in this State pursuant to Chapter 71, Title 38 shall include coverage for pediatric diagnostic imaging as recommended by a pediatric patient's healthcare provider in accordance with the provisions of this section.

       (2) An insurer, health maintenance organization, or its officer or agent, that issues or delivers to any person in this State any policy in wilful violation of the requirements of this subsection, or that denies in whole or in part a claim for coverage of pediatric diagnostic imaging recommended by a pediatric patient's healthcare provider in accordance with the provisions of this section, is subject to administrative penalties assessed pursuant to the provisions of Section 38-2-10 for each offense.

    (D)(1) Pediatric diagnostic imaging is a covered service under Medicaid's Early Periodic Screening, Diagnostic and Treatment Program administered by the Department of Health and Human Services pursuant to Chapter 6, Title 44. Pediatric diagnostic imaging recommended by a Medicaid beneficiary's healthcare provider in accordance with the provisions of this section is a reimbursable cost.

       (2) Pediatric diagnostic imaging recommended by a patient's healthcare provider in accordance with the provisions of this section for a child with End-Stage Renal Disease (ESRD) who otherwise qualifies for ESRD Medicare is a covered Medicare expense.

 

SECTION 3.  This act takes effect upon approval by the Governor.

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