H 4069 — Patient-Friendly Billing

2025-2026 Bill 4069 Text of Previous Version (Mar.(Feb.

Document has been reformatted to meet World Wide Web specifications.) Indicates  Matter  Stricken  Indicates  New  Matter    Committee  ReportA Marchbill 20,  2025TO  AMEND H.THE SOUTH CAROLINA CODE OF LAWS BY ADDING SECTION 44-7-327 SO AS TO ESTABLISH CERTAIN REQUIREMENTS PERTAINING TO PATIENT BILLING FOR HEALTH SERVICES AND SUPPLIES.

4069   Introduced by Reps.

Sessions and Magnuson   S.

Printed 3/20/25--H.

Read the first time February 20, 2025   ________   The committee on House Medical, Military, Public and Municipal Affairs To whom was referred a Bill (H.

4069) to amend the South Carolina Code of Laws by adding Section 44-7-327 so as to establish certain requirements pertaining to patient billing for health services and, etc., respectfully Report:

That they have duly and carefully considered the same, and recommend that the same do pass with amendment:

      Amend the bill, as and if amended, SECTION 1, by striking Section 44-7-327(A)(2) and inserting:

       (2) "Healthcare facility" means the same as defined in Section 44-7-130.:

           (a) acute care hospitals;

           (b) psychiatric hospitals;

           (c) alcohol and other substance use disorder hospitals;

           (d) ambulatory surgical facilities;

           (e) hospice facilities;

           (f) radiation therapy facilities;

           (g) rehabilitation facilities;

           (h) residential treatment facilities for child and adolescents;

           (i) intermediate care facilities for individuals with intellectual disabilities;

or            (j) narcotic treatment programs.

Amend the bill, as and if amended, SECTION 1, Section 44-7-327(B)(1), by striking the undesignated sentence at the end of subsection (B)(1).

Amend the bill further, SECTION 1, by striking Section 44-7-327(B)(2)(a) and (b) and inserting:

       (2)(a) The healthcare facility must notify the patient in clear and conspicuous language on the primary page of the bill, electronically or in writing, of the availability of obtaining an itemized copy electronically or in writing pursuant to itemsubsection (B)(1) and must offer the patient the ability to indicate the preferred form of the itemized bill by checking an appropriate box on the primary page of the patient bill near the indication of the amount owed.

       (b) A patient may waive the right to receive an itemized bill by marking and initialing at a specified location subsequent to the language notifying the patient of the right to an itemized bill on the primary pageelectronically or in writing.

An initial waiver of the right to an itemized bill does not prevent the patient from later receiving an itemized bill upon request.

Amend the bill further, SECTION 1, by striking Section 44-7-327(B)(3)(b) and (c) and inserting:

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

and            (c) if the healthcare facility 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 healthcare facility 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.

Amend the bill further, SECTION 1, by striking Section 44-7-327(B)(5) and inserting:

       (5) A healthcare facility may not pursue debt collection against a patient for a provided healthcare service or supply unless the healthcare facility has complied with this sectionprovided an itemized bill to the patient or the patient has waived the right to receive an itemized bill.

Renumber sections to conform.

Amend title to conform.

  S.H.

DAVIS for Committee.

    statement of estimated fiscal impact Explanation of Fiscal Impact State Expenditure This bill requires healthcare facilities that request payment from a patient after providing a healthcare service or related supply to a patient to provide the patient with a written or an electronic version of the itemized bill of the costs of each service and supply provided during the visit.

The itemized bill must be submitted by the facility no later than the thirtieth day after the facility receives a final payment on the provided service from a third party.

This bill also lists how a healthcare facility must notify the patient of their right to receive an itemized bill and allows for a patient to waive their right to receive an itemized copy.

  Further, this bill lists what an itemized bill must include, that the facility may issue the itemized bill electronically, that a patient is entitled to request an itemized bill at any time after the initial copy, that initial waiver of the right to an itemized bill does not prevent the patient from later receiving an itemized bill upon request, and that a health care facility is not able to pursue debt collection against a patient unless the facility has complied with these requirements.

Additionally, the appropriate licensing authority shall take disciplinary action against the facility for the violation as if the facility violated applicable licensing law.