H 3740 General Bill, By Meacham, Seithel, Howard, Allison, Battle, Mack, Martin, 
M. McLeod, J.H. Neal, Rodgers, Whipper, Wilkes and Young-Brickell
 A BILL TO AMEND ARTICLE 1, CHAPTER 71 OF TITLE 38, CODE OF LAWS OF SOUTH
 CAROLINA, 1976, RELATING TO ACCIDENT AND HEALTH INSURANCE, BY ADDING SECTION
 38-71-280 SO AS TO REQUIRE THAT EVERY ENTITY PROVIDING A HEALTH BENEFIT PLAN
 THAT PROVIDES COVERAGE FOR PRESCRIPTION DRUGS OR DEVICES SHALL NOT EXCLUDE OR
 RESTRICT COVERAGE FOR PRESCRIPTION CONTRACEPTIVE DRUGS OR DEVICES, TO REQUIRE
 THAT EVERY ENTITY PROVIDING A HEALTH BENEFIT PLAN THAT PROVIDES COVERAGE FOR
 OUTPATIENT SERVICES PROVIDED BY A HEALTH CARE PROFESSIONAL SHALL NOT EXCLUDE
 OR RESTRICT COVERAGE FOR OUTPATIENT CONTRACEPTIVE SERVICES, AND TO PROVIDE FOR
 INCIDENTAL AND RELATED MATTERS.

   03/16/99  House  Introduced and read first time HJ-3
   03/16/99  House  Referred to Committee on Labor, Commerce and
                     Industry HJ-4

TO AMEND ARTICLE 1, CHAPTER 71 OF TITLE 38, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO ACCIDENT AND HEALTH INSURANCE, BY ADDING SECTION 38-71-280 SO AS TO REQUIRE THAT EVERY ENTITY PROVIDING A HEALTH BENEFIT PLAN THAT PROVIDES COVERAGE FOR PRESCRIPTION DRUGS OR DEVICES SHALL NOT EXCLUDE OR RESTRICT COVERAGE FOR PRESCRIPTION CONTRACEPTIVE DRUGS OR DEVICES, TO REQUIRE THAT EVERY ENTITY PROVIDING A HEALTH BENEFIT PLAN THAT PROVIDES COVERAGE FOR OUTPATIENT SERVICES PROVIDED BY A HEALTH CARE PROFESSIONAL SHALL NOT EXCLUDE OR RESTRICT COVERAGE FOR OUTPATIENT CONTRACEPTIVE SERVICES, AND TO PROVIDE FOR INCIDENTAL AND RELATED MATTERS.

Whereas, there are approximately three million unintended pregnancies each year in the United States; and

Whereas, unintended pregnancies lead to higher rates of infant mortality, low birth weight, and maternal morbidity and threaten the economic stability of families; and

Whereas, two-thirds of women of childbearing age rely on some form of private employment-related insurance to defray their medical expenses. Now, therefore,

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

SECTION 1. Article 1, Chapter 71 of Title 38 of the 1976 Code is amended by adding:

"Section 38-71-280. (A) Every entity providing a health benefit plan that provides coverage for prescription drugs or devices shall not exclude or restrict coverage for prescription contraceptive drugs of devices. Coverage shall include coverage for the insertion or removal of and any medically necessary examination associated with the use of the prescribed contraceptive drug or device. The same deductibles, coinsurance, and other limitations as apply to prescription drugs or devices covered under the health benefit plan shall apply to coverage for prescribed contraceptive drugs or devices.

(B) Every entity providing a health benefit plan that provides coverage for outpatient services provided by a health care professional shall not exclude or restrict coverage for outpatient contraceptive services. The same deductibles, coinsurance, and other limitations as apply to outpatient services covered under the health benefit plan shall apply to coverage for outpatient contraceptive services.

(C) As used in this section, the term:

(1) 'Health benefit plan' means an accident and health insurance policy or certificate; a nonprofit hospital or medical service corporation contract; a health maintenance organization subscriber contract; or a plan provided by another benefit arrangement, to the extent permitted by the Employee Retirement Income Security Act of 1974, as amended, or by any waiver of or other exception to that act provided under federal law or regulation. 'Health benefit plan' does not mean any plan implemented or administered by the South Carolina Department of Health and Human Services or the United States Department of Health and Human Services, or any successor agency, or its representatives. 'Health benefit plan' also does not mean any of the following kinds of insurance:

(a) Accident.

(b) Credit.

(c) Disability income.

(d) Long-term care or nursing home care.

(e) Medicare supplement.

(f) Specified disease.

(g) Dental or vision.

(h) Coverage issued as a supplement to liability insurance.

( i) Workers' compensation.

( j) Medical payments under automobile or homeowners insurance.

(k) Hospital income or indemnity.

( l) Insurance under which benefits are payable with or without regard to fault and that is statutorily required to be contained in any liability policy or equivalent self-insurance.

(2) 'Insurer' includes an insurance company subject to this chapter and a health maintenance organization under Chapter 33 of this title.

(3) 'Outpatient contraceptive services' means consultations, examinations, procedures, and medical services provided on an outpatient basis and related to the use of contraceptive methods to prevent pregnancy.

(4) 'Prescribed contraceptive drugs or devices' means drugs or devices approved by the United States Food and Drug Administration for use as contraceptives and obtained under a prescription written by a health care provider authorized to prescribe medications under the laws of this State.

(D) A health benefit plan subject to this section shall not:

(1) deny eligibility or continued eligibility to enroll or to renew coverage under the terms of the health benefit plan solely for the purpose of avoiding the requirements of this section;

(2) provide monetary payments or rebates to an individual participant or beneficiary to encourage the individual participant or beneficiary to accept less than the minimum protections available under this section;

(3) penalize or otherwise reduce or limit the reimbursement of an attending provider because the provider prescribed contraceptive drugs or devices or provided contraceptive services in accordance with this section; or

(4) provide incentives, monetary or otherwise, to an attending provider to induce the provider to withhold from an individual participant or beneficiary contraceptive drugs, devices, or services."

SECTION 2. (A) This act takes effect upon approval by the Governor and applies to health benefit plans that are delivered, issued for delivery, or renewed on and after July 1, 2000.

(B) For the purposes of this act, renewal of a health benefit policy, contract, or plan is presumed to occur on each anniversary date on which coverage was first effective on the person or persons covered by the health benefit plan.