A BILL TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING SECTION 44-7-395 SO AS TO REQUIRE HOSPITALS AND OTHER MEDICAL PROVIDERS TO FILE AN INSURANCE CLAIM WITH A PATIENT'S HEALTH INSURER FOR REIMBURSEMENT OF MEDICAL COSTS AND EXPENSES.
Summary
H3089 would add a new section to the South Carolina Code requiring hospitals, healthcare facilities, and other medical providers to begin the insurance claims process with a patient’s primary health insurer within 30 days after providing treatment or another service for a personal injury. The bill is aimed at insured patients whose care is related to an injury, and it places the initial billing responsibility on the provider rather than the patient.
If a provider fails to submit the claim within the required time, the bill states that the provider forfeits the right to reimbursement for that service. The bill also makes clear that it does not limit a provider’s ability to seek reimbursement from Medicare or Medicaid where allowed by law. The act would take effect upon approval by the Governor.
Impact
The bill would create a new statutory requirement in Title 44 governing medical billing practices for injury-related care. It would affect hospitals, healthcare facilities, and other medical providers by imposing a 30-day deadline to file claims with a patient’s primary health insurer and by tying compliance to the provider’s right to payment. It would also preserve existing reimbursement pathways for Medicare and Medicaid claims, while shifting some administrative responsibility away from patients and toward providers.
Sentiment
The available voting history suggests the bill was generally well received in the House, passing 106-9 on April 30, 2025. No committee transcript is available, so there is no recorded debate to indicate detailed support or opposition arguments. The strong vote margin suggests broad agreement with the bill’s consumer-protection and billing-administration goals.
Contention
The main point of contention likely concerns the strict forfeiture penalty for providers who miss the 30-day filing deadline, since that could be viewed as harsh or administratively burdensome for hospitals and medical practices. Another possible issue is how the new requirement interacts with existing billing workflows, coordination of benefits, and personal-injury claims. The bill text itself limits the rule to insured patients and preserves Medicare and Medicaid billing, which may have reduced objections from some stakeholders.