S.C. Code Ann. § 59-10-510: Definitions.

For purposes of this article:

(1) "Private provider" means a provider who:

(a) renders Applied Behavior Analysis therapy or performs an evaluation or observation pursuant to such therapy, and includes:

(i) board-certified behavior analysts;

(ii) board-certified assistant behavior analysts;

(iii) board-certified behavior analyst-doctoral; and

(iv) registered behavior technicians under the appropriate supervision of a board-certified behavior analyst or board-certified assistant behavior analyst;

(b) provides or seeks to provide services in a South Carolina public school;

(c) is licensed by this State and in good standing or, if state licensure is not available, is certified by and in good standing with a national certification or accreditation organization; and

(d) is not an employee of a public school district or the State Department of Education.

(2) "Medically necessary service" means services that meet the following requirements:

(a) ordered by a healthcare provider within the scope of the healthcare provider's license for the treatment or remediation of functional impairments associated with a diagnosis of autism spectrum disorder;

(b) not for experimental or investigational purposes;

(c) within the generally accepted standards of medical care in the community;

(d) not solely for the convenience or personal preference of the insured, the insured's family, or the provider; and

(e) is medically necessary during school hours in the school setting.

(3) "Third-party payor" includes, but is not limited to, Medicaid, self-funded health plans, and commercial insurance.

(4) "Undue burden" has the same meaning as Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 793, as amended, and Title II of the Americans with Disabilities Act (ADA) of 1990, 42 U.S.C. Section 12101, et seq., as amended.

(5) "Fundamental alteration" has the same meaning as Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 793, as amended, and Title II of the Americans with Disabilities Act (ADA) of 1990, 42 U.S.C. Section 12101, et seq., as amended.