THE SOURCE BLOG

Spotlight on State

Spotlight on State: South Carolina

This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week.

See South Carolina page.

While South Carolina law does not mandate an all-payer claims database (APCD), the Division of Medicaid Policy Research at the University of South Carolina Institute for Families in Society maintains a private database of voluntary claims submissions. The South Carolina Department of Health and Human Services (SCDHHS), which operates the state’s Medicaid program, partnered with several agencies to launch an ambitious price and quality transparency website, SCHealthData.org. SCDHHS aims to increase transparency in health care by providing revenue and utilization data, hospital chargemasters, and comparative price statistics for common DRGS. The state also proposed legislation in both surprise billing protections and shared savings program to contain healthcare costs.

In healthcare market competition, South Carolina law requires notice to the Attorney General as well as approval for mergers and acquisitions of health facilities, but for those involving non-profit entities only. The state also requires notice to the certificate of need-issuing agency but does not require a certificate of need for healthcare facility mergers. In 2014, a merger involving Community Health Systems (CHS) was challenged by the FTC. As a condition to acquire Health Management Associates, Inc, the FTC ordered CHS to divest hospitals and related assets in Alabama and South Carolina in order to resolve concerns that the combination would substantially lessen competition for general acute care inpatient services in those markets, as well as provide prior notice of future such acquisitions for 10 years. In a private antitrust case brought in South Carolina District Court, Sisters of Charity Providence Hospital alleged that Palmetto Health conspired with an orthopedic surgery practice group to monopolize orthopedic surgery services in Richland County. The case was dismissed in the lower court and affirmed by the Fourth Circuit in 2018.

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