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COMMITTEE REPORT
April 5, 2006
H. 4351
Introduced by Reps. Ballentine, W.D. Smith, Vick, G.M. Smith, Altman, Hagood, Haley, Neilson, J.E. Smith, Haskins, Jennings, Funderburk, Jefferson, Hinson, G. Brown, Limehouse, Townsend, Miller, Agnew, Pinson, Sinclair, Bannister, Frye, E.H. Pitts, Clark, Umphlett, Leach, Bailey, Loftis, Battle, Kennedy, Anthony, Allen, Mack, Anderson, Moody-Lawrence, Mitchell, McLeod, Coleman, Clemmons, Delleney, Rutherford, R. Brown, Parks, J.H. Neal, Howard, Clyburn, Govan, Hodges, Cobb-Hunter, Hosey, J. Brown, Young, M. Hines, Weeks, Hiott, Toole, Huggins, Hardwick, M.A. Pitts, Littlejohn, Branham, Cotty, J.R. Smith, Owens, Duncan, Skelton, Mahaffey, Bales, Whipper, Stewart, McGee, Hamilton, Bowers, Perry, Viers, Dantzler, Davenport, Chellis and Herbkersman
S. Printed 4/5/06--H.
Read the first time January 10, 2006.
To whom was referred a Bill (H. 4351) to amend the Code of Laws of South Carolina, 1976, by adding Section 38-71-280 so as to require insurance coverage for treatment of pervasive developmental disorders, etc., respectfully
That they have duly and carefully considered the same and recommend that the same do pass with amendment:
Amend the bill, as and if amended, by striking all after the enacting words and inserting:
/SECTION 1. Article 3, Chapter 20, Title 44 of the 1976 Code is amended by adding:
"Section 44-20-227. (A) There is created the Autism Early Intervention Advisory Committee within the Department of Disabilities and Special Needs. The committee must be composed of the Director of the Department of Disabilities and Special Needs or his designee, who shall serve as chairman of the committee, the Director of the Department of Health and Human Services or his designee, the Superintendent of Education or his designee, the Chairman of the House Education and Public Works Committee or his designee, the Chairman of the House Ways and Means Committee or his designee, the Chairman of the Senate Education Committee or his designee, the Chairman of the Senate Finance Committee or his designee, four parents of children diagnosed with a pervasive developmental disorder appointed by the Governor, one of whom must be from a family with a household income less than two hundred and fifty percent of the federal poverty level, and an administrator of a school for special needs children.
(B) The committee shall make recommendations to the department on the administration of the Autism Early Intervention Fund. In developing its recommendations the advisory committee shall consider among other things, ages of children to receive developmental training focusing on the youngest ages feasible for treatment effectiveness, types of training or treatment options, types of conditions, proof of gains, and qualifications of providers.
(C) The department is authorized to serve persons with autistic disorder, but may, from monies in the Autism Early Intervention Fund, award grants or negotiate and contract with public or private entities to implement intervention programs for children who have been diagnosed with a pervasive developmental disorder.
(D) The Autism Early Intervention Advisory Committee shall report to the General Assembly and the Governor on the number of children participating in programs awarded grants pursuant to this section, the methodology of the treatment options, and the number of children that were mainstreamed into public or private school as a result of the therapies provided by these programs. The report must be submitted annually by December thirty-first for the duration of the program.
(E) As used in this section:
(1) 'Developmental training' means special education programs or other developmental training programs available to children diagnosed with a pervasive developmental disorder.
(2) 'Pervasive developmental disorder' means a neurological condition, including autistic disorder and Asperger's syndrome, as defined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association.
(F) The Early Autism Intervention Fund is contingent upon the General Assembly providing funding annually in the appropriations act sufficient for awarding grants and contracts in accordance with this section.
(G) This section does not establish or authorize creation of an entitlement program or benefit."
SECTION 2. This act takes effect January 1, 2007./
Renumber sections to conform.
Amend title to conform.
HARRY F. CATO for Committee.
TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 38-71-280 SO AS TO REQUIRE INSURANCE COVERAGE FOR TREATMENT OF PERVASIVE DEVELOPMENTAL DISORDERS AND TO DEFINE "PERVASIVE DEVELOPMENTAL DISORDER" AS A NEUROLOGICAL CONDITION, INCLUDING AUTISM AND ASPERGER'S SYNDROME.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Article 1, Chapter 71, Title 38 of the 1976 Code is amended by adding:
"Section 38-71-280. (A) As used in this chapter, 'pervasive developmental disorder' means a neurological condition, including autism and Asperger's syndrome, as defined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association.
(B) An individual accident and sickness insurance policy, group accident and sickness insurance policy, individual health maintenance organization contract, or group health maintenance organization contract must provide coverage for the treatment of a pervasive developmental disorder of an insured. Coverage provided under this section is limited to treatment that is prescribed by the insured's treating physician in accordance with a treatment plan. An insurer may not deny or refuse to issue coverage on, refuse to contract with, or refuse to renew, refuse to reissue, or otherwise terminate or restrict coverage on an individual under an insurance policy solely because the individual is diagnosed with a pervasive developmental disorder.
(C) The coverage required under subsection (B) must not be subject to dollar limits, deductibles, or coinsurance provisions that are less favorable to an insured than the dollar limits, deductibles, or coinsurance provisions that apply to physical illness generally under the accident and sickness insurance policy or the health maintenance organization contract."
SECTION 2. This act takes effect upon approval by the Governor and applies to all accident and sickness insurance policies and health maintenance organization contracts issued, renewed, delivered, or entered into on or after this act's effective date or July 1, 2006, whichever occurs later.
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