H*3928 (Rat #0170, Act #0098 of 1999) General Bill, By Cato
Summary: Health maintenance organizations, out-of-network coverage under point of service option, Diabetes, Insurance, Medical
    A BILL TO AMEND SECTION 38-33-50, AS AMENDED, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO THE POWERS OF HEALTH MAINTENANCE ORGANIZATIONS, SO AS TO PROVIDE THAT THOSE POWERS INCLUDE THE OFFERING OF AN OUT-OF NETWORK COVERAGE UNDER A POINT OF SERVICE OPTION, TO BE IMPLEMENTED BY REGULATIONS AND POLICY BULLETIN BY THE DIRECTOR OF THE DEPARTMENT OF INSURANCE; TO AMEND SECTION 38-33-80, AS AMENDED, RELATING TO THE PROVISION THAT EVERY ENROLLEE IN A HEALTH MAINTENANCE ORGANIZATION IS ENTITLED TO EVIDENCE OF COVERAGE, SO AS TO PROVIDE THAT FOR A POINT OF SERVICE OPTION OFFERED JOINTLY BY A HEALTH MAINTENANCE ORGANIZATION AND AN INSURER, ONLY ONE EVIDENCE OF COVERAGE IS REQUIRED AS LONG AS THE BENEFITS PROVIDED BY EACH PARTY ARE CLEARLY IDENTIFIED; TO AMEND SECTION 38-33-20, AS AMENDED, RELATING TO DEFINITIONS UNDER THE PROVISIONS REGULATING HEALTH MAINTENANCE ORGANIZATIONS, SO AS TO PROVIDE A DEFINITION FOR "EMPLOYING ENTITY"; TO AMEND SECTION 38-33-130, AS AMENDED, RELATING TO HEALTH MAINTENANCE ORGANIZATIONS, SECURITY DEPOSIT, INDIVIDUAL STOP-LOSS COVERAGE, UNPAID CLAIM LIABILITY, AND INDIVIDUAL CONVERSION POLICY, SO AS TO PROVIDE THAT AN EMPLOYING ENTITY MAY EXECUTE ONE AGREEMENT ON BEHALF OF THE EMPLOYING ENTITY AND ALL OF ITS PROVIDERS, AND PROVIDE THAT AN EMPLOYING ENTITY MAY ALSO EXECUTE ONE PARTICIPATION AGREEMENT AND ONE OF OTHER SIMILAR REQUIRED FORMS ON BEHALF OF THE EMPLOYING ENTITY AND ALL OF ITS PROVIDERS; TO AMEND THE 1976 CODE BY ADDING SECTION 38-71-46 SO AS TO PROVIDE THAT ON OR AFTER JANUARY 1, 2000, EVERY HEALTH MAINTENANCE ORGANIZATION, INDIVIDUAL, AND GROUP HEALTH INSURANCE POLICY OR CONTRACT SHALL PROVIDE COVERAGE FOR THE EQUIPMENT, SUPPLIES, 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 LEGALLY AUTHORIZED TO PRESCRIBE SUCH ITEMS WHO DEMONSTRATES ADHERENCE TO MINIMAL STANDARDS OF CARE FOR DIABETES MELLITUS AS ADOPTED AND PUBLISHED BY THE DIABETES INITIATIVE OF SOUTH CAROLINA; AND PROVIDE FOR RELATED MATTERS; AND TO PROVIDE THAT SECTION 38-71-46 APPLIES TO ALL INDIVIDUAL AND GROUP HEALTH INSURANCE AND HEALTH MAINTENANCE ORGANIZATION POLICIES ISSUED, DELIVERED, ISSUED FOR DELIVERY, OR RENEWED ON OR AFTER JANUARY 1, 2000.-AMENDED TITLE
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04/15/99	House	Introduced and read first time HJ-4
04/15/99	House	Referred to Committee on Labor, Commerce and Industry HJ-5
05/05/99	House	Committee report: Favorable with amendment Labor, Commerce and Industry HJ-3
05/06/99	House	Amended HJ-8
05/06/99	House	Read second time HJ-8
05/06/99	House	Unanimous consent for third reading on next legislative day HJ-9
05/07/99	House	Read third time and sent to Senate HJ-1
05/11/99	Senate	Introduced and read first time SJ-34
05/11/99	Senate	Referred to Committee on Banking and Insurance SJ-34
05/13/99	Senate	Recalled from Committee on Banking and Insurance SJ-11
05/18/99	Senate	Amended SJ-15
05/18/99	Senate	Read second time SJ-15
05/18/99	Senate	Ordered to third reading with notice of amendments SJ-15
05/20/99	Senate	Read third time and returned to House with amendments SJ-24
05/27/99	House	Concurred in Senate amendment and enrolled HJ-129
06/09/99		Ratified R 170
06/11/99		Signed By Governor
06/11/99		Effective date 06/11/99; Sec. 38-71-46 applies to all individual & group health insurance policies, as the case may be, issued, etc. or renewed in this State on or after 01/01/00
07/01/99		Copies available
07/06/99		Act No. 98