S0531: Healthcare Services

Legislative Summary

Amend The South Carolina Code Of Laws So As To Enact The "patients' Right To Transparency And Timely Access To Healthcare Services Act"; By Adding Section 44-116-10 So As To Define Necessary Terms; By Adding Section 44-116-20 So As To Exclude Certain Healthcare Providers From Preauthorization Requirements Who Meet A Ninety Percent Threshold Of Preauthorization Requests For Medications And Treatments During A Particular Time Period; By Adding Section 44-116-30 So As To Require A Fair And Transparent Prior Authorization Process For Medications And Treatments; By Adding Section 44-116-40 So As To Establish Timelines For Preauthorization Decisions; By Adding Section 44-116-50 So As To Prohibit Ongoing Prior Authorization Requirements For Patients Living With Chronic Conditions After Prior Authorization Has Been Provided Under Certain Circumstances; By Adding Section 44-116-60 So As To Prohibit Insurance Companies From Switching Pharmaceuticals During A Policy Year; By Adding Section 44-116-70 So As To Allow For Step Therapy Exceptions; By Adding Section 44-116-80 So As To Provide That Once Prior Authorization Is Granted, Health Carriers Must Pay For The Service With Exceptions; By Adding Section 44-116-90 So As To Require Continuity Of Care When A Patient Changes Insurance Policies; By Adding Section 44-116-100 So As To Require Certain Filings For Insurance Companies For Transparency Concerning Approval And Denial Rates; And By Adding Section 44-116-110 So As To Provide For Enforcement Of The Chapter.