Bill Text: SC S0631 | 2013-2014 | 120th General Assembly | Introduced

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Bill Title: Health and accident insurers

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2013-04-17 - Referred to Committee on Banking and Insurance [S0631 Detail]

Download: South_Carolina-2013-S0631-Introduced.html

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A BILL

TO AMEND SECTION 38-71-10, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO COVERAGE THAT MAY BE WRITTEN BY A LICENSED ACCIDENT AND HEALTH INSURER, SO AS TO PROHIBIT THE INSURER FROM DIRECTLY PAYING MONEY TO AN INSURED FOR A HEALTH CARE SERVICE PROVIDED TO THE INSURED IF THE PROVIDER RENDERED THE SERVICE SUBJECT TO THE ON-CALL COVERAGE OF THE PROVIDER, AND TO PROVIDE EXCEPTIONS.

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

SECTION    1.    Section 38-71-10 of the 1976 Code is amended to read:

"Section 38-71-10.    (A)    All A licensed accident and health insurers are entitled to insurer must:

(a)(1)    issue and deliver a service benefit contracts contract to provide for prepayment of any a health care service and to make payment directly to the provider of the services service, in whole or in part, including, but not limited to, a professional services service, any institutional care, a personal services service, and supplies.

(b)(2)    issue and deliver contracts a contract of indemnity or contracts contract providing for payment of money directly to the insureds or for them on behalf of an insured for a health care services service provided to an insured.

(B)    Notwithstanding another provision of law, a licensed accident and health insurer may not make a payment of money directly to an insured for a health care service received by the insured if the health care provider rendered the service subject to the provider's on-call coverage.

(C)    The provisions of this section do not apply to:

(1)    supplemental or secondary insurance coverage; or

(2)    a person who documents to the insurer that he has fully paid the health care provider for the service rendered."

SECTION    2.    This act takes effect upon approval by the Governor.