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Current Status Bill Number:View additional legislative information at the LPITS web site.3743 Type of Legislation:General Bill GB Introducing Body:House Introduced Date:19990316 Primary Sponsor:Simrill All Sponsors:Simrill Drafted Document Number:l:\council\bills\nbd\11216jm99.doc Companion Bill Number:650 Residing Body:House Current Committee:Ways and Means Committee 30 HWM Subject:State health insurance plan, medical; prostheses coverage for scalp-hair prostheses History Body Date Action Description Com Leg Involved ______ ________ ______________________________________ _______ ____________ House 19990316 Introduced, read first time, 30 HWM referred to Committee Versions of This Bill
TO AMEND ARTICLE 5, CHAPTER 11, TITLE 1, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO THE STATE BUDGET AND CONTROL BOARD AND INSURANCE FOR STATE EMPLOYEES AND RETIREES, BY ADDING SECTION 1-11-760 SO AS TO PROVIDE THAT BENEFITS FOR MEDICAL OR HOSPITAL EXPENSES AND COVERAGE FOR PROSTHESES SHALL INCLUDE COVERAGE FOR "SCALP-HAIR PROSTHESES", AND TO PROVIDE FOR RELATED MATTERS.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Article 5, Chapter 11, Title 1 of the 1976 Code is amended by adding:
"Section 1-11-760. (A) For the purposes of this section:
(1) 'Prosthesis' means an artificial appliance used to replace loss of natural body parts. 'Prosthesis' includes, but is not limited to, artificial arms, legs, breasts, or glass eyes.
(2) 'Scalp-hair prosthesis' means an artificial substitute or appliance made for the scalp, with hair, made for a specific individual to wear for the replacement of scalp hair.
(B) The Division of Insurance Services of the State Budget and Control Board, in effecting the insurance or renewal of any policy of group health insurance providing benefits for medical or hospital expenses and coverage for prostheses, shall ensure that each certificate holder of such insurance policy in this State receives coverage for a scalp-hair prosthesis as defined in subsection (A)(2) to be worn by the certificate holder for hair loss suffered as a result of alopecia areata, alopecia totalis, alopecia universalis, or permanent loss of scalp hair due to injury or disease. This coverage is subject to a written recommendation by the certificate holder's treating physician or other licensed medical provider stating that the scalp-hair prosthesis is a medical necessity for the certificate holder. The coverage for the scalp-hair prosthesis is subject to the same limitations and guidelines applicable for other prostheses.
(C) Every insurance company, including every health maintenance organization, licensed to do business in this State which provides to its insureds or certificate holders coverage for prostheses shall additionally provide to its insureds or certificate holders who are residents of this State and who are employed by the State or by one of its political subdivisions, including all such retirees, coverage for a scalp-hair prosthesis, as defined in subsection (A)(2), to be worn by the insured or certificate holder for hair loss suffered as a result of alopecia areata, alopecia totalis, alopecia universalis, or permanent loss of scalp hair due to injury or disease; provided, that the provisions of this subsection (C) are subject to the conditions contained in subsection (B)."
SECTION 2. This act takes effect upon approval by the Governor.
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