Overview

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.

In 2023, the state enacted the “State Health Facility Licensure Act”, eliminating references to certificate of need requirements for most health care facilities except nursing homes.  The act also requires the Medical University of South Carolina to obtain approval from the Joint Bond Review Committee and Fiscal Accountability Authority before acquiring a hospital, and establishes a certificate of need study committee to examine the effect of the repeal of the certificate of need program on the quality and quantity of access to health care in rural areas of the state. The new law also includes provisions related to licensing requirements for hospitals and ambulatory surgical facilities.

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).

State Action

Additional Resources

STATE BUDGET

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.  Between September and October, agencies submit their budget requests to the governor.  Budget hearings are held with state agencies in October.  In January, the governor submits a proposed budget to the state legislature.  The legislature adopts a budget in May. The passed budget is required to be balanced.

STATE LEGISLATURE

The state’s Legislature is comprised of 46 Senators, elected to four year terms, and 124 members of the House of Representatives, who serve two year terms.  The General Assembly is in session each year from the second Tuesday in January until the second Thursday in May; however, the session can be extended under specific circumstances.  Bills carry over from odd to even years.

KEY RESOURCES