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Indicates Matter Stricken
Indicates New Matter
AS PASSED BY THE SENATE
June 1, 2000
H. 4441
S. Printed 6/01/00--S.
Read the first time February 29, 2000.
TO AMEND SECTION 38-71-46(A) OF THE 1976 CODE RELATING TO DIABETES COVERAGE IN HEALTH INSURANCE POLICIES, SO AS TO CLARIFY OR ESTABLISH STANDARDS FOR DENIAL OF COVERAGE.
Amend Title To Conform
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Section 38-71-46(A) of the 1976 Code, as amended by Act 239 of 2000, is further amended to read:
"(A) On or after January 1, 2000, every health maintenance organization, individual and group health insurance policy, or contract issued or renewed in this State must provide coverage for the equipment, supplies, Food and Drug Administration-approved medication indicated for the treatment of diabetes, 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 who is legally authorized to prescribe such items and who demonstrates adherence to minimum standards of care for diabetes mellitus as adopted and published by the Diabetes Initiative of South Carolina. This subsection does not prohibit a health maintenance organization or an individual or a group health insurance policy from providing coverage for medication according to formulary or using network providers. Coverage must not be denied unless the health care professional demonstrates a persistent pattern of failure to adhere to the minimal standards of care and unless the health maintenance organization or insurer has first provided written notice to the health care professional that coverage will be denied if the health care professional fails to adhere to the minimal standards of care."
SECTION 2. The provisions added by this act take effect upon approval by the Governor.
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