Bill 124

                    Current Status

Bill Number:                    124
Ratification Number:            342
Act Number:                     353
Type of Legislation:            General Bill GB
Introducing Body:               Senate
Introduced Date:                19970114
Primary Sponsor:                McConnell 
All Sponsors:                   McConnell and Giese
Drafted Document Number:        council\legis\bills\bbm\10955jm.97
Date Bill Passed both Bodies:   19980422
Date of Last Amendment:         19980326
Governor's Action:              S
Date of Governor's Action:      19980526
Subject:                        Health insurance policy, medical;
                                dermatological services coverage, when;
                                dermatologists

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

------  19980617  Act No. A353
------  19980526  Signed by Governor
------  19980521  Ratified R342
Senate  19980422  Concurred in House amendment,
                  enrolled for ratification
House   19980327  Read third time, returned to Senate
                  with amendment
House   19980326  Amended, read second time,
                  unanimous consent for third reading
                  on Friday, 19980327
House   19980325  Committee report: Favorable with         26 HLCI
                  amendment
House   19970415  Introduced, read first time,             26 HLCI
                  referred to Committee
Senate  19970410  Read third time, sent to House
Senate  19970408  Amended, read second time
Senate  19970403  Made Special Order
Senate  19970312  Recalled from Committee,                 02 SBI
                  placed on the Calendar
Senate  19970114  Introduced, read first time,             02 SBI
                  referred to Committee

(A353, R342, S124)

AN ACT TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 38-71-215 SO AS TO PROVIDE THAT, IF A PRIMARY CARE PHYSICIAN MAKES A REFERRAL TO A DERMATOLOGIST, THE ENROLLEE IN A MANAGED CARE HEALTH PLAN MAY SEE THE IN-NETWORK DERMATOLOGIST TO WHOM THE ENROLLEE IS REFERRED, WITHOUT FURTHER REFERRAL, FOR A MINIMUM OF SIX MONTHS OR FOUR VISITS, WHICHEVER OCCURS FIRST, FOR DIAGNOSIS, TREATMENT, OR SURGERY FOR THE REFERRAL PROBLEM OR CONNECTED COMPLICATIONS, AND TO PROVIDE FOR RELATED MATTERS.

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

Referral to dermatologist; etc.

SECTION 1. The 1976 Code is amended by adding:

Section 38-71-215. (A) If a primary care physician makes a referral to a dermatologist, the enrollee in a managed care plan may see the in-network dermatologist to whom the enrollee is referred, without further referral, for a minimum of six months or four visits, whichever first occurs, for diagnosis, medical treatment, or surgical procedures for the referral problem or related complications.

(B) Written communication from the dermatologist should be sent to the primary care physician after each visit.

(C) An enrollee with a documented past history of malignant melanoma may be referred by his or her primary care physician to an in-network dermatologist for an annual evaluation and, as necessary, biopsy or surgery, or both.

(D) All services provided pursuant to this section are subject to contractual provisions regarding medical necessity and benefit coverage.

(E) Nothing in this section may be construed to extend benefits to an enrollee past the contract period.

Time effective

SECTION 2. This act takes effect January 1, 1999.

Approved the 26th day of May, 1998.