General Assembly Adjourns—But Work Continues in Special Session

Here’s where things stand on the major issues affecting South Carolina hospitals:

Special Session Focus: Budget and Redistricting

The governor’s special session is centered on two major unfinished items: the state appropriations act (the budget) and congressional redistricting. Procedural efforts during the final week to advance redistricting discussions fell short, leaving the issue unresolved. Now, lawmakers will revisit both topics, and in doing so, retain flexibility to take up additional legislation.

That flexibility matters. Conference committees—where House and Senate leaders reconcile differences between competing versions of bills—are also still working through several pieces of legislation important to hospitals.

Medical Malpractice Reform Remains Uncertain

Medical malpractice reform remains one of the most closely watched—and uncertain—issues. The bill is still on the Senate calendar, but its path forward is unclear.

The central sticking point involves proposed changes to liability caps. Trial attorneys have pushed to ensure any cap increases apply only to medical malpractice claims, rather than expanding to all claims under the state’s Tort Claims Act. So far, that disagreement has stalled progress.

While there is still an opportunity for the Senate to revisit the issue during special session, prospects remain slim without a compromise between stakeholders.

HALO Act Advances—With Narrower Scope

There was meaningful movement on the HALO Act in the final hours of the session. The Senate adopted an amendment narrowing the bill’s protections to healthcare workers in emergency departments, along with security officers and volunteers working in those settings.

While more limited than originally proposed, the measure still represents progress. Hospitals have long advocated for stronger legal protections for healthcare workers facing rising incidents of workplace violence.

The bill has now been assigned to a conference committee, where final negotiations will take place. While broader protections remain a priority, this step signals recognition of the risks faced by frontline emergency department staff.

Hospital Hallway Beds Bill Heads to Governor’s Desk

One significant win for hospitals came with the passage of legislation addressing emergency department overcrowding.

The bill allows hospitals, under defined emergency conditions, to use patient beds outside of traditional rooms—commonly referred to as “hallway beds.” With EDs under increasing strain, particularly from boarding and patient volume challenges, this policy provides needed flexibility.

Importantly, earlier discussions about adding provisions related to surgical smoke were set aside, allowing the core emergency department language to move forward. The bill is now headed to the Governor’s desk and is expected to be signed into law.

Medicaid Funding Boost Through Tobacco and Nicotine Taxes

Lawmakers also took steps to address a projected Medicaid funding gap. The Senate amended legislation originally focused on taxes for heat-not-burn tobacco products to include a broader range of nicotine products.

While the additional revenue will not fully close the funding shortfall, it represents a meaningful step toward stabilizing the Medicaid budget—a critical issue for hospitals given the program’s role in coverage and reimbursement across the state.

Patient-Friendly Billing Heads to Conference Committee

Efforts to improve transparency in patient billing continue to evolve. Legislation aimed at itemized, patient-friendly billing underwent significant revision late in the session.

Lawmakers returned the bill to a more workable framework after concerns were raised by hospital leaders about overly burdensome requirements—particularly the expectation of providing highly detailed, multi-page billing documents upfront.

The revised approach aims to strike a balance: offering clear, understandable billing information for patients while preserving the ability to provide detailed itemization upon request. The bill will now be finalized in a conference committee.

Celebrating Hospital Week at the State House

The final week of session also coincided with National Hospital Week, providing an opportunity to highlight the essential role hospitals play across South Carolina.

Hospital leaders engaged directly with policymakers, including key committee chairs and the governor, to discuss the challenges facing the healthcare system and the impact hospitals have on communities statewide. The governor also issued a formal proclamation recognizing Hospital Week, underscoring the importance of continued collaboration.

Looking Ahead

While the regular session has concluded, the legislative process is far from over. Special session deliberations, conference committee negotiations, and final gubernatorial action will shape the outcome of several priority issues for hospitals.

SCHA will continue to monitor developments closely and provide updates as decisions are made.

For now, the message is clear: adjournment may mark the end of the regular session, but critical work on healthcare policy remains underway.