South Carolina Advances Patient-Friendly Medical Billing Reform Bill
South Carolina lawmakers are moving forward with legislation that would impose new transparency requirements on healthcare billing practices while creating stricter procedures for disputed medical debt accounts.
H. 4069, known as the “Patient-Friendly Billing” bill, recently advanced through the Senate Medical Affairs Committee with amendments after previously passing the South Carolina House. The legislation would require healthcare facilities to provide patients with clearer billing information and establish new rules governing how disputed medical debt is handled during the collection process.
If approved by both legislative chambers and signed by Gov. Henry McMaster, portions of the bill would take effect Jan. 1, 2027.
Bill Would Require Electronic Itemized Bills
The legislation would require healthcare facilities to provide patients with written or electronic itemized bills detailing the services provided and the amounts owed. The bills must use plain-language descriptions intended to make healthcare charges easier for patients to understand.
Under the proposal, facilities would also be required to notify patients of their right to request an itemized bill, even if the patient initially declines or waives that option.
The bill’s definition of “healthcare facility” is broad and includes acute care hospitals, psychiatric hospitals, rehabilitation facilities, hospice facilities, substance-use treatment hospitals, and other licensed medical providers operating in South Carolina.
Supporters of the legislation argue that patients often struggle to understand medical billing statements and may face collection activity before they have sufficient information to verify the accuracy of charges.
Collection Activity Would Pause During Billing Disputes
One of the bill’s most closely watched provisions affects the handling of disputed medical debt accounts by collection agencies.
If either the patient or the healthcare facility identifies a billing inaccuracy, collection activity would be required to stop immediately, and the account would need to be returned to the healthcare provider for review and correction.
An earlier version of the legislation included liability protections for collection agencies handling disputed accounts. However, that language was removed during the amendment process in the Senate Medical Affairs Committee.
The removal of those protections could increase compliance and operational concerns for collection agencies servicing healthcare accounts in South Carolina.
Healthcare Providers and Collection Agencies Face Operational Changes
If enacted, the legislation would likely require substantial operational updates across healthcare revenue cycle and collections workflows.
Healthcare providers may need to upgrade billing platforms, electronic delivery systems, and patient communication procedures to comply with the proposed itemization and notification requirements. Collection agencies servicing medical accounts could also face revised account handling protocols when disputes or billing inaccuracies arise.
The delayed implementation date appears designed to give healthcare organizations, servicers, and vendors time to update technology infrastructure and compliance procedures before the law takes effect.
The bill must still receive final approval from both the House and Senate before it can be sent to the governor for signature.
