Current Status Bill Number:3583 Type of Legislation:General Bill GB Introducing Body:House Introduced Date:19950214 Primary Sponsor:Fair, All Sponsors:Fair, Jaskwhich, Tripp, Easterday, Haskins, McMahand, Herdklotz, Vaughn, Rice, Cato and Anderson Drafted Document Number:br1\18159ac.95 Residing Body:House Current Committee:Medical, Military, Public and Municipal Affairs Committee 27 H3M Subject:Hospital Fair Pricing Act
Body Date Action Description Com Leg Involved
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House 19950214 Introduced, read first time, 27 H3M
referred to Committee
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TO AMEND TITLE 44, CHAPTER 7, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO HOSPITALS, BY ADDING ARTICLE 10 SO AS TO ENACT THE HOSPITAL FAIR PRICING ACT, TO DEFINE TERMS, TO ALLOW ACUTE CARE HOSPITALS TO PURCHASE SERVICES FROM SOLE PROVIDER HOSPITALS AT A CERTAIN RATE, AND TO PROVIDE A CAUSE OF ACTION AND INJUNCTIVE RELIEF FOR VIOLATIONS; TO AMEND SECTION 44-7-180, AS AMENDED, RELATING TO THE STATE HEALTH PLAN FOR USE IN THE ADMINISTRATION OF THE CERTIFICATE OF NEED PROGRAM, SO AS TO PROVIDE THAT THE PLAN MUST CONTAIN A POLICY STATEMENT REQUIRING ACCESS TO HEALTH CARE SERVICES BY A PROVIDER SO THAT THE PROVIDER MAY OFFER THESE SERVICES ON A COMPETITIVE BASIS, WHERE COMPETITION IS PERMITTED; AND TO REQUIRE IN THE PLAN STANDARDS TO ENFORCE THIS POLICY AND STANDARDS FOR PREVENTING EXERCISE OF OR DAMAGES FROM A MARKET POWER RESULTING FROM THE EXISTENCE OF THE CERTIFICATE OF NEED PROGRAM.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Title 44, Chapter 7 of the 1976 Code is amended by adding:
Section 44-7-1350. This article may be cited as the South Carolina Hospital Fair Pricing Act.
Section 44-7-1360. As used in this article:
(1) `Affiliate' with respect to a facility means a person or entity that directly or indirectly controls, is controlled by, or is under common control with the facility, whether through ownership of voting securities, by contract, or otherwise.
(2) `Facility' means an entity or person that owns or controls, whether through the ownership of voting securities, by contract, or otherwise, directly or indirectly one or more acute care hospitals.
(3) `Sole provider facility' means a facility which provides one or more health care services within a county that are not provided in that county by any other person or entity other than an affiliate of the facility.
(4) `Sole provider service' means a health care service that is offered from one or more locations within a county only by a single facility or one or more of its affiliates or by the facility and one or more of its affiliates when there is also at least one acute care hospital located in the county that is not controlled directly or indirectly by that facility or any of its affiliates.
(5) `Health care service' means a service that is offered by an acute care hospital including, but not limited to, a service that is identified separately under a generally applicable coding, listing, or other classification or identification of medical services.
(6) `Offered price' with respect to a sole provider service in a particular county is a price offered by the sole provider facility or any of its affiliates in connection with the provision of that sole provider service under any type of reimbursement arrangement, other than the federal Medicare or Medicaid programs, which would allow a resident of that county to obtain that sole provider service in that county.
Section 44-7-1370. (A) A sole provider facility that offers a sole provider service within a county and any of a facility's affiliates that offer a sole provider service within that county must allow any other facility with an acute care hospital located within that county to purchase a sole provider service offered by the sole provider facility within that county at whatever offered prices with respect to providing that sole provider service in that county the other facility selects from time to time. An offered price must be made available without requiring that a particular volume of services be purchased and, with respect to a sole provider service, for as long as the respective offered price would have been available with respect to that sole provider service under the terms of any offer.
(B) A sole provider facility, upon receipt of a written request from another facility within a county where the sole provider facility offers a sole provider service, shall provide in writing a complete, detailed statement of all offered prices, in any form, currently offered or offered in the future by the sole provider facility or any of its affiliates with respect to each sole provider service offered by the sole provider facility or any of its affiliates within that county. The information requested must be delivered by hand or by facsimile transmission to the person specified from time to time by the facility making the request for information and:
(1) with respect to prices already offered at the time the request for pricing information is received, must be delivered to the requesting facility within ten days of the request; and
(2) with respect to prices offered after the request is made and which have not already been provided to the requesting facility, must be delivered simultaneously with the making of an offer of that pricing.
Section 44-7-1380. (A) If a sole provider facility or any of its affiliates violates or threatens to violate the provisions of Section 44-7-1370, a facility that, as a result of the actual or threatened violation, has failed or would fail to receive the benefits of Section 44-7-1370 may bring an action to recover damages or to obtain injunctive relief or both. Whenever injunctive relief or a verdict for damages or both is obtained in an action, the trial judge shall award the facility which is entitled to the damages or injunctive relief or both three times the actual damages plus the reasonable attorney's fees and costs incurred by that facility in connection with bringing the claim for damages or injunctive relief or both.
(B) An action under this section may be brought in the court of common pleas in the county in which the complaining facility maintains an acute care hospital, has its principal place of business, or conducts business.
(C) The courts are authorized to issue orders and injunctions to restrain and prevent violations of this article, and these orders and injunctions must be issued without bond."
SECTION 2. Section 44-7-180(B) of the 1976 Code, as last amended by Act 511 of 1992, is further amended by adding at the end:
"(5) a general statement that it is against the policy of the State for a provider who obtains market power in a geographic area in a service as a result of the certificate of need laws and regulations to deny a provider in that geographic area, who lacks that service, access to that service on a basis that will enable full and fair competition in services as to which competition is permitted in that area under the state plan; and
(6) standards and requirements for the enforcement of the policy set forth in item (5) including, but not limited to, restrictions and requirements to prevent price discrimination in violation of that policy."
SECTION 3. Section 44-7-180(B)(3) of the 1976 Code, as last amended by Act 511 of 1992, is further amended to read:
"(3) standards for distribution of health care facilities, beds, specified health services, and equipment including scope of services to be provided, utilization, and occupancy rates, travel time, regionalization, prevention of the exercise of or injury from any market power that may result from the existence of the certificate of need program, other factors relating to proper placement of services, and proper planning of health care facilities; and".
SECTION 4. This act takes effect upon approval by the Governor.