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TO AMEND TITLE 44 OF THE 1976 CODE BY ADDING CHAPTER 132 TO PROVIDE FOR THE DIRECT SUBMISSION OF CLAIMS FOR ANATOMIC PATHOLOGY SERVICES, TO PROVIDE FOR THE SUBMISSION AND LIMITATIONS OF BILLS FOR OUTPATIENT ANATOMIC PATHOLOGY SERVICES, AND TO PROVIDE FOR THE DEFINITION OF ANATOMIC PATHOLOGY SERVICES FOR PURPOSES OF THIS CHAPTER.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Title 44 of the 1976 Code is amended by adding:
Section 44-132-10. Except as provided in section 44-132-20, no person licensed to practice in South Carolina as a physician, surgeon, or osteopath, a dentist or dental surgeon, a nurse practitioner, or a physician's assistant shall charge, bill, or otherwise solicit payment for outpatient anatomic pathology services unless the services were rendered personally by the licensed practitioner or under the licensed practitioner's supervision.
Section 44-132-20. A person who is licensed to practice medicine in South Carolina and who is qualified as a specialist in pathology, or the professional legal entity of which the person is a shareholder, partner, employee, or owner, may submit a bill for outpatient anatomic pathology services only to:
(1) the patient directly;
(2) the responsible insurer or other third-party payor;
(3) the hospital, public health clinic, or nonprofit health clinic; or
(4) the referral laboratory or the primary laboratory.
Section 44-132-30. The health professional licensing boards of South Carolina which license and regulate the practitioners specified in Section 44-132-10, in addition to all other authority granted to them under the South Carolina Code of Laws, may revoke, suspend, or deny the renewal of the license of any practitioner who violates the provisions of this chapter. In addition, no patient, insurer, third-party payor, hospital, public health clinic, or nonprofit health clinic shall be required to reimburse such practitioners for charges or bills submitted in violation of this chapter.
Section 44-132-40. The provisions of this chapter shall not prohibit billing between laboratories for anatomic pathology services in instances where a sample or samples must be sent to another specialist.
Section 44-132-50. For purposes of this chapter, the term 'anatomic pathology services' means:
(1) histopathology or surgical pathology meaning the gross and microscopic examination of organ tissue performed by a physician or osteopath or under the supervision of a physician or osteopath;
(2) cytopathology meaning the examination of cells, from fluids, washings, brushings or smears, including the Pap test examination performed by a physician or osteopath or under the supervision of a physician or osteopath;
(3) hematology meaning the microscopic evaluation of bone marrow aspirations and biopsies performed by a physician or osteopath, or under the supervision of a physician or osteopath, and peripheral blood smears when the attending/treating physician or osteopath, or technologist requests that a blood smear be reviewed by a pathologist;
(4) sub-cellular pathology and molecular pathology; and
(5) blood-banking services performed by pathologists.
This chapter shall not apply to any clinical laboratory service that is not included in the definition of anatomic pathology as set forth in this section. Nothing contained in this chapter shall be construed to prohibit payments for anatomic pathology services by government agencies or their specified public or private agent, agency, or organization on behalf of the recipient of the services."
SECTION 2. This act takes effect upon approval by the Governor.
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