The 2025-2026 legislative session has concluded, and the SCMA advocacy team was at the State House every day during the session, working on behalf of physicians and their patients in committee rooms, on the floor, and in conversations with legislators.
This session delivered meaningful victories, a near-historic success that fell short at the final stage, and a clear roadmap for future advocacy efforts.
SCOPE OF PRACTICE
S.44 / H.3579
This legislation would have allowed physician assistants with 2,000 postgraduate hours to practice under an attestation statement without a required relationship with a supervising physician. It also would have permitted specialty changes after only 1,000 additional hours of experience. Multiple SCMA physicians testified in opposition at all three subcommittee hearings. No vote was taken, and the bill did not advance from subcommittee.
S.45 / H.3580
This bill would have granted nurse practitioners full practice authority, including diagnosing, prescribing, and ordering tests, after 2,000 postgraduate clinical hours and would have eliminated physician collaboration requirements. Multiple SCMA physicians testified in opposition at all three subcommittee hearings. No vote was taken, and the bill did not advance from subcommittee.
S.378
This legislation would have expanded pharmacist authority to include ordering laboratory tests, reporting results, and prescribing medications in certain circumstances. Multiple SCMA physicians testified in opposition at all three subcommittee hearings. A hearing was held, but no vote was taken, and the bill did not advance from subcommittee.
H.4103 / S.393
This bill would have expanded optometric scope of practice to include surgical procedures. The House bill advanced from committee but was later recommitted. No House floor vote occurred.
LOOKING AHEAD
SCMA is already preparing for the return of these proposals in 2027. Legislators are expected to pursue compromise legislation during the interim, and SCMA will remain actively engaged to represent the interests of South Carolina physicians and their patients.
S.669: Team-Based Health Care Act
This legislation would have strengthened the team-based care framework among physicians, APRNs, and PAs. Multiple physicians testified in support of preserving physician-led care at all three hearings. SCMA believes several provisions in this bill would address challenges within current collaboration and supervision models.
NON-COMPETE AGREEMENTS
H.4767
This bill would have prohibited physician non-compete agreements. The legislation passed the House and was approved by the Senate Medical Affairs Committee. However, two senators placed their names on the bill, which under Senate rules prevented a floor vote. Although the bill did not pass, it advanced further than similar legislation in previous sessions. SCMA remains committed to eliminating physician non-compete agreements in South Carolina.
MEDICAL MALPRACTICE REFORM
H.4544
Last year, the Senate passed a comprehensive tort reform bill that included medical malpractice provisions. This year, the House pursued medical malpractice reform through H.4544. The bill passed the House with strong committee and floor support. The Senate removed the bill from committee and placed it on the Senate calendar, but it was not ultimately passed before adjournment. As a result, the bill died at the end of the session. SCMA expects the General Assembly to revisit this issue in 2027, as significant stakeholder interest remains.
BILLS THAT PASSED
H.3254
Allows the Board of Medical Examiners to waive certain examination requirements for physicians who demonstrate current board certification, recent recertification, or 150 hours of specialty-relevant Category I CME. This legislation reduces barriers for qualified physicians seeking licensure in South Carolina.
H.3842
Authorizes physical therapists to certify patients for temporary handicap placards. Permanent placards may still be certified only by a physician, APRN, or PA.
H.3831: Smart Heart Act
Requires cardiac emergency response plans, accessible AEDs, and related training in all public schools and school athletic venues.
H.4343
Requires physicians, nurses, and physician assistants in designated specialties and care settings to complete one hour of human trafficking awareness and prevention continuing education every six years.
S.146: Long-Term Care Residents Bill of Rights
Allows long-term care residents to designate one individual who may visit during declared states of emergency. The legislation was enacted in response to the isolation many residents experienced during the COVID-19 pandemic.
H.4069
Establishes billing requirements for healthcare facilities, including ambulatory surgery centers (ASCs), but does not apply to independently owned physician practices. The bill increases billing transparency, requires itemized bills before collection actions may occur, and aligns South Carolina with broader price transparency trends.
PHYSICIAN ENGAGEMENT MATTERS
Legislators consistently report that physician testimony and real-world patient care experiences influence legislative decisions. During the 2027-2028 legislative session, SCMA and SCMedPAC will continue monitoring hundreds of bills affecting the practice of medicine. The mission remains clear: protect patient safety, preserve physician-led care, and ensure South Carolina remains a state where physicians can focus on practicing medicine rather than navigating unnecessary regulatory burdens. The work accomplished at the State House helps shape the future of healthcare in South Carolina. Physician engagement remains essential, and we hope you will join us in these efforts in the year ahead.
