AN ACT TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY AMENDING SECTION 42-15-90, RELATING TO FEES OF ATTORNEYS AND PHYSICIANS AND HOSPITAL CHARGES APPROVED BY THE COMMISSION, SO AS TO REQUIRE THE COMMISSION TO ESTABLISH MEDICAL FEE SCHEDULES AND RELATED SYSTEMS.
Summary
H3874 amends South Carolina’s workers’ compensation law governing medical fees paid for treatment of injured workers. The bill directs the Workers’ Compensation Commission, working with a cost containment committee, to establish a medical fee schedule and related enforcement and review procedures for medical services provided by medical practitioners, excluding hospital inpatient and outpatient services and ambulatory surgery centers. In doing so, the commission may base the schedule in whole or in part on a federally funded program and may use reimbursement methodologies tied to the CMS Resource Based Relative Value Scale (RBRVS), including single or multiple conversion factors.
The bill also requires annual review and revision of the fee schedules, with consideration of the medical consumer price index and workers’ compensation fee schedules in neighboring states. If the commission proposes an annual increase or decrease of more than 10 percent, it must hold an evidentiary hearing, and that decision is subject to expedited appeal to the Administrative Law Court, which may affirm, modify, revert, or otherwise adjust the fee schedule. The bill further requires a public hearing for stakeholder input before finalizing annual updates and specifies the membership of the cost containment committee, representing providers, insurers, employers, injured workers, and the commission.
Impact
The bill changes Section 42-15-90 of the South Carolina Code to give the Workers’ Compensation Commission clearer authority to create and manage medical fee schedules for workers’ compensation medical services. It adds a structured annual review process, hearing requirements, appellate review for large fee changes, and a stakeholder-driven committee process. The practical effect is to standardize how medical provider payments are set and adjusted in workers’ compensation cases, while preserving commission oversight and judicial review for major changes.
Sentiment
The voting history suggests broad bipartisan support and little visible opposition: the House passed the bill 106-0, the Senate gave it 45-0 on second reading, and the House later concurred in Senate amendments 110-0. That pattern indicates the bill was generally viewed as a technical or administrative improvement to the workers’ compensation system rather than a controversial policy shift.
Contention
No committee transcript or recorded debate is provided, and the unanimous votes suggest there was no major public contention in the legislative process. The main policy balance built into the bill is between cost containment and access to care: employers and insurers are likely to favor tighter fee controls, while medical providers and injured-worker advocates may focus on ensuring adequate reimbursement and access to primary and specialist care. The bill addresses that balance by requiring stakeholder input, annual review, and judicial review for large fee schedule changes.