Bill 4585

                    Current Status

Bill Number:                    4585
Ratification Number:            428
Act Number:                     351
Type of Legislation:            General Bill GB
Introducing Body:               House
Introduced Date:                19960208
Primary Sponsor:                Klauber 
All Sponsors:                   Klauber 
Drafted Document Number:        pt\2230jm.96
Date Bill Passed both Bodies:   19960521
Date of Last Amendment:         19960501
Governor's Action:              S
Date of Governor's Action:      19960529
Subject:                        Drugs used to treat cancer,
                                insurance provisions

Body    Date      Action Description                       Com     Leg Involved
______  ________  _______________________________________  _______ ____________

------  19960606  Act No. A351
------  19960529  Signed by Governor
------  19960523  Ratified R428
Senate  19960521  Concurred in House amendment, 
                  enrolled for ratification
House   19960501  Senate amendments amended,
                  returned to Senate with amendment
Senate  19960425  Read third time, returned to House
                  with amendment
Senate  19960425  Amended
Senate  19960423  Read second time, notice of
                  general amendments
Senate  19960416  Committee report: Favorable              02 SBI
Senate  19960321  Introduced, read first time,             02 SBI
                  referred to Committee
House   19960320  Read third time, sent to Senate
House   19960319  Amended, read second time
House   19960313  Committee report: Favorable with         26 HLCI
                  amendment
House   19960208  Introduced, read first time,             26 HLCI
                  referred to Committee

(A351, R428, H4585)

AN ACT TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 38-71-275 SO AS TO PROVIDE THAT NO INSURANCE POLICY WHICH PROVIDES COVERAGE FOR DRUGS SHALL EXCLUDE COVERAGE OF ANY SUCH DRUG USED FOR THE TREATMENT OF CANCER ON THE GROUNDS THAT THE DRUG HAS NOT BEEN APPROVED BY THE FEDERAL FOOD AND DRUG ADMINISTRATION FOR THE TREATMENT OF THE SPECIFIC TYPE OF CANCER FOR WHICH THE DRUG HAS BEEN PRESCRIBED, AND TO PROVIDE FOR RELATED MATTERS.

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

Coverage of certain drugs not to be excluded; etc.

SECTION 1. The 1976 Code is amended by adding:

"Section 38-71-275. (A) No insurance policy which provides coverage for drugs shall exclude coverage of any such drug used for the treatment of cancer on the grounds that the drug has not been approved by the Federal Food and Drug Administration for the treatment of the specific type of cancer for which the drug has been prescribed; provided, that such drug is recognized for treatment of that specific type of cancer in one of the standard reference compendia or in the medical literature.

(B) This section shall not be construed to:

(1) alter existing law with regard to provisions limiting the coverage of drugs that have not been approved by the Federal Food and Drug Administration;

(2) require coverage for any drug when the Federal Food and Drug Administration has determined its use to be contraindicated;

(3) require coverage for experimental drugs not otherwise approved for any indication by the Federal Food and Drug Administration;

(4) create, impair, alter, limit, modify, enlarge, abrogate, or prohibit reimbursement for drugs used in the treatment of any other disease or condition.

(C) For purposes of this section:

(1) `Insurance policy' means an individual, group, or blanket policy written by a medical expense indemnity corporation, a hospital service corporation, a health care service plan contract, or a private insurance plan issued, amended, delivered, or renewed in this State or which provides insurance for residents of this State.

(2) `Standard reference compendia' means:

(a) the United States Pharmacopoeia Drug Information;

(b) the American Medical Association Drug Evaluations; or

(c) the American Hospital Formulary Service Drug Information.

(3) `Medical literature' means two articles from major peer-reviewed professional medical journals that have recognized, based on scientific or medical criteria, the drug's safety and effectiveness for treatment of the indication for which it has been prescribed unless one article from major peer-reviewed professional medical journals has concluded, based on scientific or medical criteria, that the drug is unsafe or ineffective or that the drug's safety and effectiveness cannot be determined for the treatment of the indication for which it has been prescribed."

Time effective

SECTION 2. This act takes effect one hundred twenty days after approval by the Governor.

Approved the 29th day of May, 1996.