Amended

April 09, 2024

H. 4622

Introduced by Reps. Sessions, Pope, Guffey, Mitchell, King and Hart

S. Printed 04/09/24--H.                                                                       [SEC 4/11/2024 11:01 AM]

Read the first time January 09, 2024

________

A bill

TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING SECTION 44-7-327 SO AS TO ESTABLISH CERTAIN REQUIREMENTS PERTAINING TO ITEMIZED PATIENT BILLING FOR HEALTH CARE SERVICES AND SUPPLIES.

    Amend Title To Conform

Be it enacted by the General Assembly of the State of South Carolina:

SECTION 1.  Article 3, Chapter 7, Title 44 of the S.C. Code is amended by adding:

    Section 44-7-327.  (A) For purposes of this section:

       (1) "Debt collection" means an action, conduct, or practice in collecting, or in soliciting for collection, consumer debts that are due or alleged to be due a creditor.

       (2) "Health care provider" means a hospital or ambulatory surgical facility as defined in S.C. Code Section 44-7-130.

       (3) "Health care service" means a service a health care provider provides to an individual to diagnose, prevent, treat, alleviate, cure, or heal a human health condition, illness, injury, or disease.

    (B)(1) Beginning January 1, 2025, a health care provider that requests payment from a patient after providing a health care service or related supply to the patient shall submit with the request a written, itemized bill of the alleged remittance sought for each service and supply provided to the patient during the patient's visit to the health care provider.  The provider must submit the itemized bill no later than the thirtieth day after the provider receives a final payment on the provided service or supply from a third party.

       (2) The itemized bill must include:

           (a) a plain language description, in accordance with the most current billing reading level requirements and guidance provided by the Centers for Medicare and Medicaid Services, for each distinct health care service and quantity of supply the health care provider provided to the patient;

           (b) the amount the provider alleges is due from the patient for each service and supply provided to the patient; and

           (c) if the provider sought or is seeking reimbursement from a third party, any billing code submitted to the third party, and the patient's responsibility amount due to the provider pursuant the third party insurer's explanation of benefits. The third party insurer's explanation of benefits shall set forth a specific explanation of the patient's responsibility amount including, but not limited to, whether the amount is a deductible, coinsurance, or noncovered charges.

       (3) A health care provider may issue the itemized bill electronically, including through a patient portal on the provider's Internet website.

       (4) A patient is entitled to obtain from the health care provider an itemized bill on request at any time after the itemized bill is initially issued under item (1).

       (5) A health care provider may not pursue debt collection against a patient for a provided health care service or supply unless the provider has complied with this section.

       (6) A collection agency is not liable under this section for billing inaccuracies provided by the health care provider.  If any inaccuracies are determined, the collection agency must cease collection activities and return the account back to the health care provider.

    (C) The appropriate licensing authority shall take disciplinary action against the provider for the violation as if the provider violated an applicable licensing law.

SECTION 2.  This act takes effect upon approval by the Governor.

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