Bill > H4972

This bill mandates that health insurance policies in South Carolina that cover cancer chemotherapy treatment must also cover scalp cooling therapy, which is a treatment used to prevent or reduce hair loss during chemotherapy. Insurers will be required to notify patients about the availability and coverage of scalp cooling therapy when approving chemotherapy treatment, and this notice must include details on how to obtain the service. Furthermore, chemotherapy treatment facilities, defined as any licensed entity administering chemotherapy, will not be eligible for payment or reimbursement from insurance carriers for chemotherapy services unless they offer scalp cooling system therapy to all chemotherapy patients for whom it is medically appropriate, which includes having at least one operational system available and informing patients of its availability. The bill also specifies that scalp cooling equipment and its operation, even if managed by a third-party provider separate from the treatment facility, must be covered and can be billed separately, and that coverage may be subject to standard deductibles and copayments. The Department of Health will establish procedures for certifying facility compliance, and noncompliance can lead to penalties. This new requirement applies to all individual and group health insurance policies, health maintenance organizations, and the State Health Plan, and will take effect six months after the Governor approves the act.

Business and Industry

https://www.scstatehouse.gov/billsearch.php?billnumbers=4972&session=126&summary=B