South Carolina Statutes

Among other things, this Act amends the CLSC §40-47-0140 by adding a provision to allow physician assistants to be considered a primary care provider or a mental health provider when the PA is practicing in the medical specialties required for a physician to be a primary care provider or mental health provider.

Enacted throughS132

Health insurance coverage offered in connection with a group health plan that provides both medical and surgical benefits and mental health or substance use disorder benefits may not impose any aggregate lifetime limit or any annual limit on mental health or substance use disorder benefits if there is no aggregate lifetime limit imposed on medical and surgical benefits. If the coverage includes an aggregate lifetime limit, on substantially all medical and surgical benefits, the coverage must either:
(i) apply the same lifetime limit or annual limit to both the medical and surgical benefits and the mental health or substance use disorder benefits; or (ii) not include any aggregate lifetime limit or annual limit on mental health or substance use disorder benefits that is less than the applicable lifetime limit or annual limit.
The same coverage may not impose financial requirements and treatment limitations that are more restrictive for mental health or substance use disorder benefits than those imposed on medical and surgical benefits.
S.C. Code Ann. § 38-71-880 continues on to provide exceptions to these mandates, such as insurance coverage provided by small employers, and also excepts plans that would experience an increase in cost as a result of compliance with this section.

Amended by S.C. SB 390.

A health insurance plan must provide coverage for treatment of a mental health condition and may not establish a rate, term, or condition that places a greater financial burden on an insured for access to treatment for a mental health condition than for access to treatment for a physical health condition in similar settings and treatment modalities. Any deductible or out-of-pocket limits required under a health insurance plan must be comprehensive for coverage of both mental health and physical health conditions.
S.C. Code Ann. § 38-71-290 continues on to define “mental health condition” and discusses requirements for eligibility for coverage.

Amended by S.C. SB 390.

S.C. Code Ann. § 1-11-780 briefly mandates the State Employee Insurance Program to continue providing mental health parity and states that the program is not under the jurisdiction of the Department of Insurance.

Amended by S.C. S.B. 49.