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.
See below for an overview of existing South Carolina state mandates. Click on citation tab for detailed information of specific statutes (click link to download statute text).
Current Legislative Session: 1/12/2021 - 1/7/2022 (2021-2022 term). *Current session bill updates are ongoing. Check back weekly for updates.
South Carolina operates on a yearly budget cycle. South Carolina’s fiscal year begins on July 1 and ends on June 30 in the following year.
REGULATION & ENFORCEMENT
- In January 2014, the Federal Trade Commission and Community Health Systems, Inc. agreed to a settlement in connection with that provider’s proposed $7.6 billion acquisition of rival health system Health Management Associates, Inc. The FTC announced that the settlement requires Community Health Systems, one of the nation’s largest hospital operators, to divest hospitals and related assets, including outpatient facilities, in Alabama and South Carolina as a condition of the acquisition. Find the FTC case summary and related documents here.
- South Carolina’s CON program was suspended by the Department of Health and Environmental Control after Governor Nikki Haley issued a line-item veto in 2013 eliminating funding for the program. A challenge to the decision to suspend the program was issued by healthcare providers in the S.C. Supreme Court (Amisub of South Carolina, Inc. et al. v. South Carolina Department of Health and Environmental Control, Op. No. 27382 (S.C. Sup. Ct. filed April 14, 2014)). The court ultimately held that the Department has a non-discretionary statutory responsibility to administer the CON program and enforce the CON Act, notwithstanding the governor’s intention to withdraw funding from the program. The CON program is currently active again; however, the legislature is poised to make legislative changes to the process.