Wednesday, December 14, 2005

Here's the bill

TREATMENT FOR PERVASIVE DEVELOPMENTAL DISORDERS

AN ACT 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) may 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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