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COMMITTEE REPORT
April 13, 2005
S. 108
S. Printed 4/13/05--S.
Read the first time January 11, 2005.
To whom was referred a Bill (S. 108) to amend the Code of Laws of South Carolina, 1976, by adding Section 15-75-45 so as to create a cause of action for theft of health care, etc., respectfully
That they have duly and carefully considered the same and recommend that the same do pass with amendment:
Amend the bill, as and if amended, by striking the bill in its entirety and inserting the following:
TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 15-75-45 SO AS TO CREATE A CAUSE OF ACTION FOR UNCOMPENSATED RECEIPT OF HEALTH CARE SERVICES WHEN A PERSON SECURES PERFORMANCE OF SUCH SERVICES, HAS RECEIVED INSURANCE PROCEEDS OR THIRD PARTY PAYMENT TO PAY FOR SUCH SERVICES, AND AFTER RECEIVING PROPER NOTICE HAS NOT REMITTED THE PAYMENT TO THE HEALTH CARE PROVIDER; TO ESTABLISH NOTICE REQUIREMENTS, A SCHEDULE OF DAMAGES, INCLUDING ACTUAL DAMAGES AND LIQUIDATED DAMAGES AS A PERCENTAGE OF THE ACTUAL DAMAGES, AND DEFENSES TO THIS CAUSE OF ACTION.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Chapter 75, Title 15 of the 1976 Code is amended by adding:
"Section 15-75-45. (A) For purposes of this section:
(1) 'Reasonable charges' mean the usual and customary charges for the region as agreed upon between the health care services provider and the insurance company for the delivery of the health care services.
(2) 'Patient' means the person who received the services or who is the parent or guardian for the person who received the services.
(B) Unless otherwise agreed to verbally or in writing, a patient engages in the uncompensated receipt of health care services if the patient willfully and knowingly:
(1) secures performance of a health care service which is provided only for compensation;
(2) has received insurance proceeds as determined by the agreement between the insurance company and the heath care service provider or has received payment for health care services from a third party directed in writing for the specific health care service; and
(3) does not remit payment to the health care provider as provided in subsection (D).
(C) If payment is not made more than ninety days after the health care services are provided, a notice separate from the regular billing notices must be sent by the health care provider to the address of record for the patient by registered or certified mail. Unless returned by the post office, this separate notice is considered to be received no later than ten days after mailing.
(D) When a person fails to pay the reasonable charges within ninety days for health care services provided, or thirty days after a patient has received payment for the health care services from a third party through settlement, verdict, or other arrangements, a health care provider may bring an action against a patient for failure to pay the reasonable charges, and is allowed to allege liquidated damages as an additional remedy if the health care service provider can prove, by a preponderance of the evidence, that the patient received insurance proceeds or a third party payment in the amount of the reasonable charges for the health care services provided. The liquidated damages must be alleged in accordance with the following:
(1) for a first occurrence by a patient, actual damages plus ten percent of actual damages;
(2) for a second occurrence by the same patient, actual damages plus twenty percent of actual damages; or
(3) for a third or subsequent occurrence by the same patient, actual damages plus thirty percent of actual damages.
(E) A health care provider may request liquidated damages on the recovery of insurance proceeds or third party payment only for the amount of proceeds or payments made on the health care services provider's claim. If the proceeds or payments have been pro rated because the insurance proceeds or third party payments are less than the total value of the health care services provided, the health care provider, when alleging liquidated damages, must do so only on his pro rata share.
(F) It is a defense to an action brought pursuant to this section that:
(1) the patient secured the performance of the health care service by giving a postdated check to the health care service provider and the health care service provider performing the service or any other person presented the check for payment before the date on the check;
(2) the health care services were not rendered in a competent manner by the health care service provider or the health care service provider's services failed to meet the accepted standard of care for similar health care service providers;
(3) the health care services were covered under a health care insurance plan and payment owed by the health care insurance company has not yet been received by the health care provider or the patient for the services provided to the patient; or
(4) the notices of payment due were not sent as provided by subsection (C).
(G) A health care service provider who accepts a down payment for compensation in order to perform health care services for a patient and fails to perform the services is subject to a cause of action for reimbursement of the down payment made and is also subject to a claim for liquidated damages in accordance with the following:
(1) for a first occurrence by the health care service provider, actual reimbursement plus ten percent of actual reimbursement;
(2) for a second occurrence by the same health care service provider, actual reimbursement plus twenty percent of actual reimbursement; or
(3) for a third or subsequent occurrence by the same health care service provider, actual reimbursement plus thirty percent of actual reimbursement.
(H) Nothing in this section is construed to require any person to violate or fail to conform to the requirements of the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended, and regulations adopted pursuant to that act."
SECTION 2. This act takes effect upon approval by the Governor and applies to health care services rendered on and after the effective date of this act. /
Renumber sections to conform.
Amend title to conform.
CHAUNCEY K. "GREG" GREGORY for Committee.
TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 15-75-45 SO AS TO CREATE A CAUSE OF ACTION FOR THEFT OF HEALTH CARE SERVICES WHEN A PERSON SECURES PERFORMANCE OF SUCH SERVICES, HAS RECEIVED INSURANCE PROCEEDS OR THIRD PARTY PAYMENT TO PAY FOR SUCH SERVICES, AND WITHIN NINETY DAYS OF RECEIVING PROPER NOTICE HAS NOT REMITTED THE PAYMENT TO THE HEALTH CARE PROVIDER; TO ESTABLISH NOTICE REQUIREMENTS, A SCHEDULE OF DAMAGES, INCLUDING ACTUAL DAMAGES AND A PERCENTAGE OF THE ACTUAL DAMAGES, AND DEFENSES TO THIS CAUSE OF ACTION.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Chapter 75, Title 15 of the 1976 Code is amended by adding:
"Section 15-75-45. (A) Absent an agreement providing otherwise, a person engages in the theft of health care services if the person:
(1) intentionally or knowingly secures performance of a health care service which is provided only for compensation;
(2) has received insurance proceeds or payment from a third party for health care services; and
(3) does not remit payment to the health care provider as provided in subsection (C).
(B) If payment is not made when the health care services are provided, notice of payment due must be sent by the health care service provider by registered or certified mail, return receipt requested, to the address of record for the person who received the services, or who is a guardian or an agent for the person who received the services. Written notice, which must be separate from the regular billing notices provided by the health care provider, given in accordance with this subsection is presumed to be received no later than ten days after it was sent unless returned by the post office.
(C) When a person fails to pay within ninety days for health care services rendered, a cause of action is created pursuant to subsection (A) for actual damages for nonpayment of services rendered. The health care service provider who brings an action against a person for failure to pay for services as provided in subsection (A) is entitled to allege liquidated damages in accordance with the following:
(1) for a first occurrence by a person, actual damages plus ten percent of actual damages;
(2) for a second occurrence by the same person, actual damages plus twenty percent of actual damages; or
(3) for a third or subsequent occurrence by the same person, actual damages plus thirty percent of actual damages.
(D) It is a defense to an action brought pursuant to this section that:
(1) the defendant secured the performance of the health care service by giving a postdated check to the person performing the service and the person performing the service or any other person presented the check for payment before the date on the check;
(2) the services were not rendered in a competent manner by the health care provider or the health care provider's services fail to meet the accepted standard of care for similar health care service providers;
(3) the services were covered under a health care insurance plan and payment owed by the health care insurance company has not yet been received by the health care provider for the services provided to the person; or
(4) the notices of payment due are not sent as provided by subsection (B).
(E) A health care service provider who accepts a down payment for compensation in order to perform health care services for a person and fails to perform the services is subject to a cause of action for reimbursement of the down payment made and is also subject to allege liquidated damages in accordance with the following:
(1) for a first occurrence by the health care service provider, actual reimbursement plus ten percent of actual reimbursement;
(2) for a second occurrence by the same health care service provider, actual reimbursement plus twenty percent of actual reimbursement; or
(3) for a third or subsequent occurrence by the same health care service provider, actual reimbursement plus thirty percent of actual reimbursement.
(F) Any inconsistent provision of this section does not supercede any provision of the South Carolina High Cost and Consumer Loans Act, Sections 37-23-10 et seq."
SECTION 2. This act takes effect upon approval by the Governor and applies to health care services rendered on and after the effective date.
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