Legislative Recap, Offseason Activity, and 2026 Preview
The first regular session of the 126th South Carolina General Assembly adjourned on May 8, 2025. The second year of the session will convene on January 13, 2026. While the legislature has been out of session, significant activity continued during the interim. Below is a recap of the first year, a summary of offseason developments, and a preview of what to expect in the second year.
2025 SESSION RECAP
Several SCMA-supported bills were enacted into law:
• H.4067 – Hospital Emergency Departments
Requires all hospitals with emergency departments to have at least one physician physically present on-site and responsible whenever the emergency department is open.
• H.3996 – Anesthesiologist Assistants
Increases the allowable supervision ratio from 1:2 to 1:4 (anesthesiologist to anesthesiologist’s assistants).
• Graduate Medical Education (GME) Funding
The South Carolina Department of Health and Human Services received an additional $10 million in GME funding to help address the physician workforce shortage. This funding targets five specialties with the most critical needs: OB/GYN, family medicine, pediatrics, radiology, and ophthalmology.
OFFSEASON ACTIVITY
The Senate Medical Affairs Subcommittee held hearings on September 10–11 for several scope-of-practice bills. SCMA remains actively engaged in opposing these proposals and provided testimony from 15 witnesses. Additional hearings are expected, and SCMA will continue its advocacy efforts.
• S.44 – Physician Assistants
Would allow PAs with more than 2,000 hours of postgraduate clinical experience to practice independently. It also permits specialty transitions after 1,000 supervised hours and mandates payment parity with physicians.
• S.45 – APRN Practice Authority
Would authorize APRNs (excluding CRNAs) to practice independently after completing 2,000 clinical hours post-licensure and carrying malpractice insurance.
• S.378 – Pharmacists
Would permit pharmacists to order and administer lab tests, report results and refer follow-up care, and prescribe certain drugs and medical devices in specified circumstances.
2026 SESSION PREVIEW
Alongside continued opposition to the above scope-of-practice expansions, SCMA will advocate for several key bills in the upcoming session:
• S.46 – Healthcare Contracts
Declares noncompete agreements and the corporate practice of medicine to be contrary to South Carolina public policy.
• S.531 / H.4562 – Healthcare Services (Prior Authorization Reform)
Includes a broad set of reforms:
» Implements “gold carding” for providers
» Establishes clear timelines for prior authorization decisions
» Prohibits mid-year formulary changes
» Allows exceptions to step therapy protocols
» Requires payment once prior authorization is approved
» Ensures continuity of care when patients change insurance
» Introduces transparency requirements for insurers
• S.424 – Charity Care Deduction
Allows an income tax deduction for physicians providing qualified charity care.
• H.4544 – Medical Malpractice
Modifies conditions under which non-economic damage caps apply and clarifies the definition of an “occurrence.”
