A bill

to amend the South Carolina Code of Laws by adding Section 38-71-42 so as to REQUIRE HEALTH MAINTENANCE ORGANIZATIONS, INDIVIDUAL OR GROUP HEALTH INSURANCE POLICIES, AND INSURANCE CONTRACTS TO PROVIDE COVERAGE FOR CERTAIN TESTS FOR THE EARLY DETECTION OF CARDIOVASCULAR DISEASE; and by amending Section 1-11-710, relating to THE BOARD OF DIRECTORS OF THE PUBLIC EMPLOYEE BENEFIT AUTHORITY'S DUTY so as to REQUIRE coverage of CERTAIN TESTS FOR THE EARLY DETECTION OF CARDIOVASCULAR DISEASE.

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

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

Section 38-71-42.(A) Every health maintenance organization, individual or group health insurance policy, and insurance contract issued or renewed in this State must provide coverage for tests as set forth in subsection (B) for the early detection of cardiovascular disease for an insured who:

(1) is a male older than forty-five years of age and younger than seventy-six years of age, or a female older than fifty-five years of age and younger than seventy-six years of age;

(2) is diabetic; and

(3) has a risk of developing coronary heart disease, based on a score derived using the Framingham Heart Study coronary prediction algorithm, that is intermediate or higher.

(B) The minimum coverage that must be provided is up to two hundred dollars for the following noninvasive screening tests for atherosclerosis and abnormal artery structure and function every five years, performed by a national organization recognized by the director of the Department of Insurance:

(1) computed tomography scanning measuring coronary artery calcification; or

(2) ultrasonography measuring carotid intima-media thickness and plaque.

SECTION 2.Section 1-11-710 of the S.C. Code is amended by adding:

(F)(1) The plan approved by the board must provide coverage for tests set forth in Section 38 71 42(B) for the early detection of cardiovascular disease.

(2) The plan must be for an employee, retiree, or dependent who meets the criteria set forth in Section 38 71 42(A), and the coverage must be provided in a manner consistent with Section 38 71 42(B).

SECTION 3.This act takes effect upon approval by the Governor.

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