South Carolina · statute · S.C. Code tit. 44, ch. 6 · 56 active provisions
As used in this chapter: (1) "Department" means the State Department of Health and Human Services. (2) "Office" means the Revenue and Fiscal Affairs Office. (3) "Costs of medical education" means the direct and indirect teaching costs as defined under Medicare. (4) "Market basket index" means the index used by the fede…
There is created the State Department of Health and Human Services which shall be headed by a Director appointed by the Governor, upon the advice and consent of the Senate. The director is subject to removal by the Governor pursuant to the provisions of Section 1-3-240.
The department shall: (1) administer Title XIX of the Social Security Act (Medicaid), including the Early Periodic Screening, Diagnostic and Treatment Program, and the Community Long-Term Care System; (2) be designated as the South Carolina Center for Health Statistics to operate the Cooperative Health Statistics Progr…
In administering home- and community-based waiver programs, the department shall, to the extent possible, maintain the waiver status of an eligible family member of a member of the armed services who maintains his South Carolina state residence, regardless of where the service member is stationed. Consequently, a perso…
For all health and human services interagency programs provided for in this chapter, the department shall have the following duties: (1) Prepare and approve state and federal plans prior to submission to the appropriate authority as required by law for final approval or for state or federal funding, or both. Such plans…
The State Department of Health and Human Services may collect administrative fees associated with accounts receivable for those individuals or entities which negotiate repayment to the agency. The administrative fee may not exceed one and one-half percent of the amounts negotiated and must be remitted to the State Trea…
In carrying out the duties provided for in Section 44-6-30 the department shall: (1) Contract for health and human services eligibility determination with performance standards regarding quality control as required by law or regulation. (2) Contract for operation of certified Medicaid management information claims proc…
A state plan must be prepared by the department for each program assigned to it and the department must also prepare resource allocation recommendations based on such plans. The resource allocation recommendations must be approved pursuant to state and federal law. The state plans must address state policy and priority…
The department must submit to the Governor, the State Fiscal Accountability Authority, Revenue and Fiscal Affairs Office, and the Executive Budget Office, and the General Assembly an annual report concerning the work of the department including details on improvements in the cost effectiveness achieved since the enactm…
The department may promulgate regulations to carry out its duties. All state and local agencies whose responsibilities include administration or delivery of services which are covered by this chapter shall cooperate with the department and comply with its regulations.
The department employees shall have such general duties and receive such compensation as determined by the director. The director shall be responsible for administration of state personnel policies and general department personnel policies. The director shall have sole authority to employ and discharge employees subjec…
A Medicaid provider, outside of the geographical boundary of South Carolina but within the South Carolina Medicaid Service Area, as defined by R. 126-300(B) of the Code of State Regulations, prior to the effective date of the amendments to Section 1-1-10, which are effective January 1, 2017, shall not lose status as a…
(A) Pharmacy services are a benefit under South Carolina Medicaid, subject to approval by the federal Centers for Medicare and Medicaid Services. The department shall establish a fee schedule for the list of pharmacy services. (B)(1) The following services are covered pharmacy services that may be provided to a Medicai…
The General Assembly finds that: (1) There are citizens who cannot afford to pay for hospital care because of inadequate financial resources or catastrophic medical expenses. (2) Rising health care costs and the growth of the medically indigent population have increased the strains on the health care system with a grow…
The following sections shall be known and may be cited as the "South Carolina Medically Indigent Assistance Act".
(A) To provide cost containment incentives for providers of care to Medicaid recipients, the department shall convert the Medicaid hospital reimbursement system from a retrospective payment system to a prospective payment system by October 1, 1985. The prospective payment system includes, at a minimum, the following el…
(A) Every fiscal year the State Treasurer shall withhold from the portion of the Local Government Fund allotted to the counties a sum equal to fifty cents per capita based on the population of the several counties as shown by the latest official census of the United States. The money withheld by the State Treasurer mus…
(A) There is created the South Carolina Medically Indigent Assistance Program administered by the department. The program is authorized to sponsor inpatient hospital care for which hospitals shall receive no reimbursement. A general hospital equipped to provide the necessary treatment shall: (1) admit a patient sponsor…
(A) There is created the Medicaid Expansion Fund into which must be deposited funds: (1) collected pursuant to Section 44-6-146; (2) collected pursuant to Section 12-23-810; and (3) appropriated pursuant to subsection (B). This fund must be separate and distinct from the general fund. These funds are supplementary and…
(A) By August first of each year, the department shall compute and publish the annual target rate of increase for net inpatient charges for all general hospitals in the State. The target rate of increase will be established for a twelve-month period from October first through September thirtieth of the following year.…
(A) As used in this section: (1) "Office" means the Revenue and Fiscal Affairs Office. (2) "Council" means the Data Oversight Council. (3) "Committee" means the Joint Legislative Health Care Planning and Oversight Committee. (B) There is established the Data Oversight Council comprised of: (1) one hospital administrato…
(A) Patient records received by counties, the department, or other entities involved in the administration of the program created pursuant to Section 44-6-150 are confidential. Patient records gathered pursuant to Section 44-6-170 are also confidential. The Revenue and Fiscal Affairs Office shall use patient-identifiab…
The department may promulgate regulations pursuant to the Administrative Procedures Act. Appeals from decisions by the department are heard pursuant to the Administrative Procedures Act, Administrative Law Judge, Article 5, Chapter 23 of Title 1 of the 1976 Code. The department shall promulgate regulations to comply wi…
(A) A person who commits a material falsification of information required to determine eligibility for the Medically Indigent Assistance Program is guilty of a misdemeanor and, upon conviction, must be fined not more than five hundred dollars or imprisoned for not more than one year, or both. (B) Unless otherwise speci…
All applications for admission to a nursing home must contain a notice, to be signed by the applicant, stating: "Eligibility for Medicaid-sponsored long-term care services is based on income and medical necessity. To qualify for assistance through the Medicaid program, a nursing home patient must need intermediate or s…