South Carolina 2025-2026 Regular Session Status: In Committee 1 R cosponsors

H 4795 — Pharmacy Benefits Manager drug modifications

Last action — Member(s) request name added as sponsor: Crawford

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  1. ✓
    Introduced
  2. 2
    In Committee
  3. 3
    Passed House
  4. 4
    Passed Senate
  5. 5
    To Executive
  6. 6
    Enacted

This bill is in committee in the House. Introduced December 16, 2025. It must pass committee before a floor vote.

Next likely step: a committee vote, then a floor vote in the House.

Prognosis

Stalled 26% · moderate confidence

Where this bill stands today.

Odds of enactment

Low

How often bills like it became law.

  • In Committee

    Current position in the legislative process.

  • 12 sponsors

    12 primary, 0 co-sponsors signed on.

  • Single-party support

    Sponsorship is currently within one party (1 R).

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

Summary

A BILL TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING SECTION 38-71-2247 SO AS TO PROVIDE REQUIREMENTS FOR DRUG COVERAGE MODIFICATIONS BY PHARMACY BENEFITS MANAGERS.

Bill Text

What changed in the latest version

51 added · 12 removed

Plain-language change summary

The latest version of Bill H 4795 introduces new rules for how pharmacy benefits managers can modify drug coverage in South Carolina. Specifically, it states that any changes to coverage can only occur during the renewal of a health plan, must apply uniformly to all similar health plans, and requires that affected parties receive written notice at least 60 days prior to the change. This is important because it aims to improve transparency and protect consumers from unexpected alterations to their drug coverage.

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2025-2026 Bill 4795 Text of Previous Version (Dec.
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17, 2025) - South Carolina Legislature Online South Carolina General Assembly126th Session, 2025-2026Bill 4795Indicates Matter StrickenIndicates New Matter(Text matches printed bills.
Document has been reformatted to meet World Wide Web specifications.)                 A bill   TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING SECTION 38-71-2247 SO AS TO PROVIDE REQUIREMENTS FOR DRUG COVERAGE MODIFICATIONS BY PHARMACY BENEFITS MANAGERS.
  Be it enacted by the General Assembly of the State of South Carolina:
  SECTION 1.  Article 21, Chapter 71, Title 38 of the S.C.
Code is amended by adding:
      Section 38-71-2247.  (A) A health benefit plan issuer may modify drug coverage provided under a health benefit plan if:
       (1) the modification occurs at the time of coverage renewal;
       (2) the modification is effective uniformly among all group health benefit plan sponsors covered by identical or substantially identical health benefit plans or all individuals covered by identical or substantially identical individual health benefit plans, as applicable;
and        (3) no later than the sixtieth day before the date the modification is effective, the issuer provides written notice of the modification to the commissioner, each affected group health benefit plan sponsor, each affected enrollee in an affected group health benefit plan, and each affected individual health benefit plan holder.
    (B) A modification affecting drug coverage that requires notice under subsection (A) includes:
       (1) removing a drug from a formulary;
       (2) adding a requirement that an enrollee receive prior authorization for a drug;
       (3) imposing or altering a quantity limit for a drug;
       (4) imposing a step-therapy restriction for a drug;
and        (5) moving a drug to a higher cost-sharing tier unless a generic drug alternative to the drug is available.
    (C) A health benefit plan issuer may elect to offer an enrollee in the plan the option of receiving notifications required by this section by email.
    (D) A patient may knowingly and voluntarily waive protections afforded them under (A), but cannot be induced or coerced by any means to do so.
Any waiver made in violation of this subsection is void.
  SECTION 2.  This act takes effect upon approval by the Governor.
----XX---- This web page was last updated on December 17, 2025 at 01:51 PM
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Action History

  1. Member(s) request name added as sponsor: Crawford

  2. Member(s) request name added as sponsor: Taylor

  3. Member(s) request name added as sponsor: Guest

  4. Member(s) request name added as sponsor: White

  5. Member(s) request name added as sponsor: Kilmartin

  6. Referred to Committee on Labor, Commerce and Industry

  7. Introduced and read first time

  8. Referred to Committee on Labor, Commerce and Industry

  9. Prefiled

Sponsors

Sponsorship breakdown

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12 sponsors · 0 co-sponsors · 158 not signed on

Sponsors (12)

Co-sponsors (0)

None.

Not signed on (158)

158 members have not signed on to this bill.

Show all 158 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does H 4795 do?
A BILL TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING SECTION 38-71-2247 SO AS TO PROVIDE REQUIREMENTS FOR DRUG COVERAGE MODIFICATIONS BY PHARMACY BENEFITS MANAGERS.
Who sponsors H 4795?
H 4795 is sponsored by Representative Heath Sessions, Carla M. Schuessler (Republican), Representative Sylleste H. Davis, Representative Brandon L. Cox, Representative M. Brian Lawson, Representative Cody T. Mitchell, Representative Thomas E. "Tommy" Pope, Representative John Gregory "Jay" Kilmartin, Representative Joseph S. "Joe" White, Representative Thomas Duval "Val" Guest, Jr., Representative Bill Taylor, and Representative Heather Ammons Crawford.
What is the current status of H 4795?
This bill is in committee in the House. Introduced December 16, 2025. It must pass committee before a floor vote.
Where can I track H 4795?
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