Healthcare (Medicaid)

H 3948 increases the Personal Needs Allowance (PNA) for Medicaid-eligible nursing home residents in South Carolina, which covers personal expenses like clothing, toiletries, and small purchases. Starting January 1, 2025, the allowance will adjust annually based on the Social Security cost-of-living adjustment (capped at federal limits) and must be at least $100 per month. The bill also clarifies that accrued PNA amounts for residents as of June 1, 2024, will not count as assets during their stay, and prohibits using the allowance for Medicaid-covered items like incontinence supplies or food. This directly affects nursing home residents qualifying for Medicaid and ensures the allowance remains accessible for non-medical personal needs.

A BILL TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY AMENDING SECTION 38-71-2200, RELATING TO DEFINITIONS, SO AS TO DEFINE "LOW-VOLUME PHARMACY"; BY ADDING SECTION 38-71-2270 SO AS TO RESTRICT PHARMACY BENEFITS MANAGERS FROM REIMBURSEMENT UNDER CERTAIN CONDITIONS; BY AMENDING SECTION 38-71-2230, RELATING TO PHARMACY BENEFITS MANAGER PROHIBITIONS, SO AS TO PROHIBIT ADDITIONAL ACTIONS AND TO REMOVE THE PROHIBITION ON CLAIMS RECONCILIATION ACTIVITIES; BY AMENDING SECTION 38-71-2260, RELATING TO CONSTRUCTION AND APPLICATION, SO AS TO REMOVE ANTISTEERING PROVISIONS; BY AMENDING SECTION 38-71-2350, RELATING TO APPLICATION AND EXCEPTIONS, SO AS TO REMOVE A REFERENCE TO MEDICAID; BY ADDING SECTION 38-71-2280 SO AS TO PERMIT THE SOUTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES TO ASSUME DIRECT RESPONSIBILITY FOR ALL SOUTH CAROLINA MEDICAID PHARMACY SERVICES; BY ADDING SECTION 38-71-2290 SO AS TO EMPOWER THE ATTORNEY GENERAL TO BRING AN ACTION IN THE NAME OF THE STATE AGAINST SOMEONE ENGAGING IN UNLAWFUL ACTS PURSUANT TO THIS ACT; AND BY REPEALING SECTION 38-71-2240 RELATING TO PLACEMENT OF DRUGS ON THE MAXIMUM ALLOWABLE COST LIST.

A BILL TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING SECTION 44-6-120 SO AS TO PROVIDE THAT BEGINNING JANUARY 1, 2026, AN ADULT SIXTY-FIVE YEARS OF AGE OR YOUNGER WHOSE INCOME IS AT OR BELOW ONE HUNDRED THIRTY-THREE PERCENT OF THE FEDERAL POVERTY LEVEL, WITH A FIVE PERCENT INCOME DISREGARD, IS ELIGIBLE FOR MEDICAID AS PROVIDED FOR IN THE PATIENT PROTECTION AND AFFORABLE CARE ACT, AND AMENDMENTS TO THAT ACT.

A BILL TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING CHAPTER 145 TO TITLE 44 SO AS TO ALLOW REIMBURSEMENT FOR DOULA SERVICES UNDER CERTAIN CIRCUMSTANCES AND TO REQUIRE COVERAGE OF SUCH SERVICES THROUGH PRIVATE INSURANCE AND MEDICAID, WITH EXCEPTIONS; TO SET FORTH CRITERIA FOR MEDICAID COVERAGE OF DOULA SERVICES; TO CREATE A SCOPE OF PRACTICE FOR DOULAS; TO PROVIDE FOR THE ESTABLISHMENT OF A DOULA CERTIFICATION ORGANIZATION AND TO REQUIRE THE ORGANIZATION TO PROMULGATE REGULATIONS FOR STATEWIDE CERTIFICATION; TO PROVIDE FOR THE CREATION OF A STATEWIDE REGISTRY FOR CERTIFIED DOULAS; AND FOR OTHER PURPOSES; AND BY ADDING SECTION 38-71-134 SO AS TO REQUIRE CERTAIN INSURANCE CONTRACTS TO PROVIDE COVERAGE FOR THE SERVICES OF PERINATAL DOULAS AND TO REQUIRE UTILIZATION REPORTING BY THE DEPARTMENT OF INSURANCE.