§ 44-6-150 — Medically Indigent Assistance Program; reporting of charges for sponsored patients; duties of commission; duty to provide unreimbursed medical care to indigent persons.

South Carolina § 44-6-150

• Jurisdiction: South Carolina
• Title 44: HEALTH
• Ch. 6: DEPARTMENT OF HEALTH AND HUMAN SERVICES

Text

(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 sponsored by the program; and (2) accept the transfer of a patient sponsored by the program from a hospital which is not equipped to provide the necessary treatment. In addition to or in lieu of an action taken affecting the license of the hospital, when it is established that an officer, employee, or member of the hospital medical staff has violated this section, the South Carolina Department of Health and Environmental Control shall require the hospital to pay a civil penalty of up to ten thousand dollars. (B) Hospital charges for patients sponsored by the Medically Indigent Assistance Program must be reported to the Revenue and Fiscal Affairs Office pursuant to Section 44-6-170. (C) In administering the Medically Indigent Assistance Program, the department shall determine: (1) the method of administration including the specific procedures and materials to be used statewide in determining eligibility for the program; (a) In a nonemergency, the patient shall submit the necessary documentation to the patient's county of residence or its designee to determine eligibility before admission to the hospital. (b) In an emergency, the hospital shall admit the patient pursuant to Section 44-7-260. If a hospital holds the patient financially responsible for all or a portion of the inpatient hospital bill, and if the hospital determines that the patient could be eligible for the program, it shall forward the necessary documentation along with the patient's bill and other supporting information to the patient's county of residence or its designee for processing. A county may request that all hospital bills incurred by its residents sponsored by the program be submitted to the county or its designee for review. (2) the population to be served, including eligibility criteria based on family income and resources. Eligibility is determined on an episodic basis for a given spell of illness. Eligibility criteria must be uniform statewide and may include only those persons who meet the program's definition of medically indigent; (3) the health care services covered; (4) a process by which an eligibility determination can be contested and appealed; and (5) the program may not sponsor a patient until all other means of paying for or providing services have been exhausted. This includes Medicaid, Medicare, health insurance, employee benefit plans, or other persons or agencies required by law to provide medical care for the person. Hospitals may require eligible patients whose gross family income is between one hundred percent and two hundred percent of the federal poverty guidelines, to make a copayment based on a sliding payment scale developed by the department based on income and family size. (D) Nothing in this section may be construed as relieving hospitals of their Hill-Burton obligation to provide unreimbursed medical care to indigent persons.

Legislative History

HISTORY: 1985 Act No. 201, Part II, SECTION 19C; 1986 Act No. 335, SECTION 1; 1989 Act No. 189, Part II, SECTION 35C; 1993 Act No. 130, SECTION 1; 1993 Act No. 181, SECTION 1050.