H 4460 General Bill, By J. Brown, A.W. Byrd, McMahand and D. Williams
 A Bill to amend the Code of Laws of South Carolina, 1976, by adding Section
 38-71-270 so as to provide that nothing in Title 38 may limit an insurer or
 other third party payor from determining the scope of its benefits and other
 terms of its contracts with providers except that the contract providing
 coverage to an insured may not exclude the right of assignment of benefits to
 a provider at the same benefit rate as paid to a contract provider.

   01/18/96  House  Introduced and read first time HJ-3
   01/18/96  House  Referred to Committee on Labor, Commerce and
                     Industry HJ-3

A BILL

TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 38-71-270 SO AS TO PROVIDE THAT NOTHING IN TITLE 38 MAY LIMIT AN INSURER OR OTHER THIRD PARTY PAYOR FROM DETERMINING THE SCOPE OF ITS BENEFITS AND OTHER TERMS OF ITS CONTRACTS WITH PROVIDERS EXCEPT THAT THE CONTRACT PROVIDING COVERAGE TO AN INSURED MAY NOT EXCLUDE THE RIGHT OF ASSIGNMENT OF BENEFITS TO A PROVIDER AT THE SAME BENEFIT RATE AS PAID TO A CONTRACT PROVIDER.

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

SECTION 1. The 1976 Code is amended by adding:

"Section 38-71-270. Nothing in this title may be construed to limit an insurer, health maintenance organization, preferred provider organization, health care service corporation, or other third party payor from determining the scope of its benefits or services or any other terms of its group or individual insured, or both, subscriber or enrollee contracts nor from negotiating contracts with licensed providers on reimbursement rates or any other lawful provisions, except that the contract providing coverage to an insured may not exclude the right of assignment of benefits to a provider at the same benefit rate as paid to a contract provider."

SECTION 2. This act takes effect July 1, 1996.