(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 administrator;
(2) the chief executive officer or designee of the South Carolina Hospital Association;
(3) one physician;
(4) the chief executive officer or designee of the South Carolina Medical Association;
(5) one representative of major third-party health care payers;
(6) one representative of the managed health care industry;
(7) one nursing home administrator;
(8) three representatives of nonhealth care-related businesses;
(9) one representative of a nonhealth care-related business of less than one hundred employees;
(10) the executive vice president or designee of the South Carolina Chamber of Commerce;
(11) a member of the Governor's office staff;
(12) the director or his designee of the South Carolina Department of Health and Environmental Control;
(13) the executive director or his designee of the State Department of Health and Human Services
The members enumerated in items (1) through (10) must be appointed by the Governor for three-year terms and until their successors are appointed and qualify; the remaining members serve ex officio. The Governor shall appoint one of the members to serve as chairman. The office shall provide staff assistance to the council.
(C) The duties of the council are to:
(1) make periodic recommendations to the committee and the General Assembly concerning the collection and release of health care-related data by the State which the council considers necessary to assist in the formation of health care policy in the State;
(2) convene expert panels as necessary to assist in developing recommendations for the collection and release of health care-related data;
(3) approve all regulations for the collection and release of health care-related data to be promulgated by the office;
(4) approve release of health care-related data consistent with regulations promulgated by the office;
(5) recommend to the office appropriate dissemination of health care-related data reports, training of personnel, and use of health care-related data.
(D) The office, with the approval of the council, shall promulgate regulations in accordance with the Administrative Procedures Act regarding the collection of inpatient and outpatient information. No data may be released by the office except in a format recommended by the council and consistent with regulations. Before the office releases provider identifiable data the office must determine that the data to be released is for purposes consistent with the regulations as promulgated by the office and the release must be approved by the council and the committee. Provided, however, committee approval of the release is not necessary if the data elements and format in the release are substantially similar to releases or standardized reports previously approved by the committee. The council shall make periodic recommendations to the committee and the General Assembly concerning the collection and release of health care-related data by the State. Regulations promulgated by the office mandating the collection of inpatient or outpatient data apply to every provider or insurer affected by the regulation regardless of how the data is collected by the provider or insurer. Every effort must be made to utilize existing data sources.
(E) Information may be required to be produced only with respect to admissions of and treatment to patients after the effective date of the regulations implementing this section, except that data with respect to the medical history of the patient reasonably necessary to evaluation of the admission of and treatment to the patient may be required.
(F) The office shall convene a Health Data Analysis Task Force composed of technical representatives of universities and other private sector and public agencies including, but not limited to, health care providers and insurers to make recommendations to the council concerning types of analyses needed to carry out this section.
(G) All general acute care hospitals and specialized hospitals including, but not limited to, psychiatric hospitals, alcohol and substance abuse hospitals, and rehabilitation hospitals shall provide inpatient and financial information to the office as set forth in regulations.
All hospital-based and freestanding ambulatory surgical facilities as defined in Section 44-7-130, hospital emergency rooms licensed under Chapter 7, Article 3, and any health care setting which provides on an outpatient basis radiation therapy, cardiac catherizations, lithotripsy, magnetic resonance imaging, and positron emission therapy shall provide outpatient information to the office as set forth in the regulation. Other providers offering services with equipment requiring a Certificate of Need shall provide outpatient information to the office. Additionally, licensed home health agencies shall provide outpatient information to the office as set forth in the regulation.
Release must be made no less than semiannually of the patient medical record information specified in regulation to the submitting hospital and other information specified in regulation to the hospital's designee. However, the hospital's designee must not have access to patient identifiable data.
(H) If a provider fails to submit the health care data as required by this section or regulations promulgated pursuant to this section, the office may assess a civil fine of up to five thousand dollars for each violation, but the total fine may not exceed ten thousand dollars.
(I) A person, as defined in Section 44-7-130, seeking to collect health care data or information for a registry shall coordinate with the office to utilize existing data collection formats as provided for by the office and consistent with regulations promulgated by the office. With the exception of information that may be obtained from the Office of Vital Records, Department of Health and Environmental Control, in accordance with Section 44-63-20 and Regulation 61-19 and disease information required to be reported to the Department of Health and Environmental Control under Sections 44-29-10, 44-29-70, and 44-31-10 and Regulations 61-20 and 61-21 and notwithstanding any other provision of law, no hospital or health care facility or health care professional required by this section to submit health care data is required to submit data to a registry which has not complied with this section.
HISTORY: 1985 Act No. 201, Part II, Section 19C; 1989 Act No. 189, Part II, Section 35F; 1991 Act No. 105, Section 3; 1993 Act No. 130, Section 3; 1993 Act No. 181, Section 1053; 1995 Act No. 74, Section 1; 2018 Act No. 246 (H.3895), Sections 8.A, 8.B, eff July 1, 2018.
Effect of Amendment
2018 Act No. 246, Section 8.A, in (A)(1), deleted "Office of Research and Statistics of the" preceding "Revenue and Fiscal Affairs Office"; and in (B), deleted (12), relating to a representative from the Humans Services Coordinating Council, and redesignated (13) to (14) as (12) to (13), deleted (15), relating to the chairman or his designee of the State Health Planning Committee, and made nonsubstantive changes.
2018 Act No. 246, Section 8.B, in (H), deleted "Section 44-6-175 or" following "as required by this section or", and substituted "this section, the office" for "those sections, the Office of Research and Statistics" following "promulgated pursuant to".
Structure South Carolina Code of Laws
Chapter 6 - Department Of Health And Human Services
Section 44-6-10. Creation of commission; members; term; conflict of interests.
Section 44-6-30. Duties and limitations.
Section 44-6-35. Medicaid waiver protections.
Section 44-6-50. Contracts with other agencies; program monitoring.
Section 44-6-70. Preparation of state plan and resource allocation recommendations.
Section 44-6-80. Annual and interim reports.
Section 44-6-90. Promulgation of regulations; other agencies to cooperate with commission.
Section 44-6-100. Personnel of commission; duties; compensation.
Section 44-6-110. Medicaid providers; boundary clarification.
Section 44-6-115. Covered Medicaid pharmacy services.
Section 44-6-132. Legislative findings and intent.
Section 44-6-135. Short title.
Section 44-6-140. Medicaid hospital prospective payment system; cost containment measures.
Section 44-6-155. Medicaid Expansion Fund.
Section 44-6-160. Target rate of increase for net inpatient charges; excessive increases; penalties.
Section 44-6-200. Falsification of information; penalties.
Section 44-6-220. Notice requirements on nursing home admission applications.
Section 44-6-300. Child development services to be established.
Section 44-6-310. Expansion of existing child development services.
Section 44-6-320. Appropriations.
Section 44-6-400. Definitions.
Section 44-6-420. Enforcement actions; considerations; proportionality to violations.
Section 44-6-470. Fines; use of funds collected.
Section 44-6-530. Federal jurisdiction.
Section 44-6-540. Authority for rulemaking, and to ensure compliance with Medicaid participation.
Section 44-6-610. Citation of article.
Section 44-6-620. Definitions.
Section 44-6-630. Creation of GAPS program; purpose.
Section 44-6-650. Eligibility; benefits.
Section 44-6-660. Evaluation of cost effectiveness; annual report.
Section 44-6-720. Requirements for qualifying for undue hardship waiver.
Section 44-6-725. Promissory notes received by Medicaid applicant or recipient.
Section 44-6-1010. Pharmacy and Therapeutics Committee established; membership.
Section 44-6-1040. Preferred drug list program; procedures to be included.
Section 44-6-1050. Prior authorization for drug; refills; appeals.