The South Carolina Senate Medical Affairs Subcommittee is getting to work four months before session begins in January 2026. The Senate Subcommittee has called two hearings with stacked agendas of bills to approve. Most of these bills either regulate and update regulations in state law for health-related jobs and industry standards. I have reviewed both lists and have provided a highlight breakdown of the 11 bills that will be heard this Wednesday (September 10th) and Thursday (September 11th) in the State Senate:

September 10th Hearing

S.44 – Physician Assistants

S.44 is a very dense bill that adds and amends several laws related to physician assistants. Here are some of the highlights:

• SECTION 1. PA may only practice pursuant to an attestation statement that he (1) possesses more than 2,000 hours of postgraduate clinical practice as a licensed PA; (2) possesses more than 1,000 hours of practice experience after transitions to a new medical specialty of practice with supervising physician. (Section 40-47-937(A))
• SECTION 3. Adds two more seats to the State Board of Medical Examiners (BME) that must be PAs and appointed by the Governor, resulting in the final board count increasing from 13 seats to 15 seats.
• SECTION 12. updates wording for State Code Section 40-47-965 related to prescribing and dispensing drugs.
• SECTION 14. adds more reasons for the board to discipline a PA and resulting consequences.

S.45 – Advanced Practice Registered Nurse Practice Authority

S.45 adds and updates state law mainly regarding Advanced Practice Registered Nurse (APRN) and Certified Nurse-Midwife. Here are the main highlights:

• SECTION 1. Requires an APRN to do the following to attain full practice authority under Section 40-33-31(B): (1) complete 2,000 clinical hours in advanced practice nursing after initial APRN licensure by the board; (2) possess malpractice insurance; (3) attest compliance to the board; (4) provide documentation of compliance to the board; (5) receive full practice authority approval from the board. “Full practice authority” is detailed under subsection (F) of this Section.
• SECTION 2. Updates the requirements for Certified Nurse-Midwives to hold a minimum of a master’s degree in the specialty area from a program accredited by the American Commission for Midwifery Education (ACME) or another accredited program as approved by the board.
• SECTION 3. Updates law in Section 40-33-34, including allowing APRNs with full practice authority to order substances.

S.376 – Removing Barriers for Foreign Doctors (Similar Bill Just Passed By NC)

S.376 allows the State Board of Medical Examiners to grant a provisional license to practice medicine in South Carolina to any applicant from the following countries: Australia, Ireland, Israel, New Zealand, Singapore, South Africa, Switzerland, the United Kingdom, and Canada. The board is allowed to add other countries to this list.

While legislators think they are addressing the doctor shortage, they are missing the mark by creating a shortcut for foreign doctors that will most likely result in a cheaper salary base for the monopoly hospital systems and while providing worse care to South Carolinians.

At least 18 states have enacted similar laws since 2023, including Illinois, Massachusetts, Minnesota, and most recently, North Carolina.

For a further deep dive into this bill, check out Conservatruth’s latest summary HERE.

S.378 – Pharmacists

Expands pharmacists ability to initiate, order, and administer tests. strikes out “flu and COVID” and replaces with “laboratory” tests.

Limits pharmacists ability to prescribe drugs, drug categories, and devices to: (1) do not require a new diagnosis, (2) are minor, (3) have a test to guide diagnosis or clinical decision-making waived under the federal Clinical Laboratory Improvement Amendments of 1988, and (4) in the judgement of the pharmacist as patient emergencies.

S.669 – Creation of Team Based Health Care Committee

S.669 adds Chapter 48 to Title 40 to regulate advanced practice registered nurses (nurse practitioner, certified nurse midwife, and clinical nurse specialist), physician assistants, and anesthesiologist’s assistant.

Section 40-48-20 requires APRNs, PA,s and AAs to practice as part of a patient care team, regardless of setting, corporate structure, or practice ownership. This includes (B) practice agreements and the scope of practice guidelines that must contain the following to delineate how the patient care team physician will fulfill his obligations of collaboration with NPs, CNSs, CNMs, or supervision of PAs:

• (1) method and frequency the patient care team physician will use to review patient charts. Health records to ensure clinical quality delivered by subordinates;
• (2) guidelines that outlines how the patient care team physician and subordinates will be available to patients and to the team for collaboration/consultation;
• (3) the frequency of visits to the patient by the patient care team physician if the physician does not practice in the same physical location as the subordinates; and
• (4) the method that will be used for evaluation, improvement, and outcomes of the patient care team.

(C) Requirements for patients to be fully informed of all aspects of team-based health care:

• (1) APRNs, PAs, and AAs must disclose that they are licensed;
• (2) APRNs, PAs, and AAs with doctorates may not use the title “doctor” during patient encounter without advising that they are not a physician; and
• (3) member of patient care team must disclose at least once a year the name of the team physician and how to contact/follow-up with the physician.

(D) No requirements for physician to be physically located at the same site as the patient care team but the physician or his designee must be available “through telephone or other electronic means” during all house when care is offered to patients on the care team.

(F) Practice agreements must be reviewed by the team based health care committee.

(G)(1) Physician must notify team of resignation 90 days beforehand and if no physician will assume the role then the team based health care committee must appoint a physician.

Section 40-48-30 creates a 13 member team based health care committee that will jointly work with the Board of Medical Examiners (BME) and the Board of Nursing for “team-based health care” in South Carolina. Two must be licensed APRNs appointed by the Board of Nursing, five must be physicians appointed by the Board of Medical Examiners, two must be PA appointed by the board of Medical Examiners, one must be an AA appointed by the Board of Medical Examiners, one physician serving ex officio must be appointed by the BME, one must be a member of the Board of Nursing (serving ex officio), and one must be a member of the public appointed by the Governor.

Section 40-48-40 (A) requires the South Carolina Department of Health and Human Services in collaboration with the Board of Medical Examiners, Board of Nursing, and the SC Department of Public health to recommend proposed incentives for APRNs, PAs, and physicians to practice as part of a patient care team, specially in “rural and underserved areas.” This incentives are to include but are not limited to:

(1) loan repayment or grant programs; (2) payment models that encourage active use of data and quality metrics; (3) payment model that integrate primary health care with public health, social services, and behavioral health; (4) increased use of telehealth services; (5) increased Graduate Medical Education funding; (6) tax policy to encourage medical related workers to practice in State, particularly “rural and underserved” areas; (7) incentives to make South Carolinians healthier; (8) increased funding for mobile health units; (9) incentives to select medical programs and schools to accept students from rural areas; (10) incentives to residency programs to accept graduates from SC medical schools; (12) tax policy to encourage select medical workers to provide charity health care to underserved populations; and (13) creation and support of pipeline programs in state high schools/colleges to enter into needed healthcare professions.

(B) Allows all organizations, groups, or interested individuals (specifically naming the SC Office of Rural Health and the SC Area Health Education Consortium) to submit recommendation to the Department for consideration.

September 11th Hearing

S.160 – Creating a Joint Government Agency to Regulate Dietitians

S.160 adds Chapter 21, Article 1 to Title 40 to establish regulations for dietitians through encouraging “the cooperation of member states in regulating multistate practice of licensed dietitians” and “vest all member states with the authority to hold a licensed dietitian accountable for meeting all state practice laws…”

This bills establishes Section 40-21-130 that outlines what a state must do to participate in the compact. Some of these requirements include states to have to license and regulate the practice of dietetics, a place to receive and investigate complaints, “fully” participate in the compact’s data system, notify the compact of any adverse action/investigative information regarding licensees, and utilizing procedures for “considering the criminal history record information of applicants for an initial compact privilege.”

Furthermore, it allows member states to set and collect compact privilege fees.

S.160 adds Section 40-21-140 that outlines the qualifications a dietitian must have to “exercise the compact privilege” includes (but is not limited to):

• either a master’s degree or doctoral degree that is accredited with an agency recognized by the US Department of Education and determined by the compact commission whether or not it is acceptable, OR an academic degree in a foreign country of equivalence that is (a) accredited as determined by the compact commission and (b) involves practice experience, or (c) has completed an examination approved by the compact commission;
• pay any applicable fees;
• Meet any jurisprudence requirements; and
• report to the compact commission any adverse action, encumbrance, or restriction on a license taken by any non-member state.

S.160 adds Section 40-21-150 establishes rules for licensees and home state licenses and moving states.

Section 40-21-170 gives a remote state authority in accordance with existing state law. This authority includes (but is not limited to) taking adverse actions against licensee’s compact privilege, subpoenas for hearings and investigations, sharing data, etc.

Section 40-21-180 creates and establishes a joint government agency consisting of memberships from other member states that have enacted the Dietitian Licensure Compact Commission. The one delegate allowed will be chosen by the member state’s licensing authority and that delegate will act as the primary administrator of the licensing authority. other delegated will be determined by rule of the compact commission.

This section also allow the joint government agency to purchase insurance and bonds, assess and collect fees, accept any and all forms of money, lease/purchase/retain property whether it is property/real/personal/or mixed, borrow money, appoint committees, establish an executive committee, and so much more.

Section 40-21-190 outlines the development and operations of a coordinated data system that will be run by the compact commission. This data system will keep the following information of licensees: (1) identifying information; (2) licensure data; (3) adverse actions against a license or compact privilege; (4) nonconfidential information related to alternative program participation; (5) any denial of application for licensure; (6) current investigative information; and (7) other information as determined by the compact commission.

Section 40-21-210 allows the executive and judicial branches abilities to implement and enforce this compact.

S.453 – Teledentistry

S.453 adds Article 5 to Chapter 15, Title 40 of the State Code to be entitled “Teledentistry” that establishes standard regulations for dentists via online communication to only be used (1) for emergent care; (2) in connection with a public health program; or (3) to make an initial diagnosis.

H.3223 – Telehealth for Veterinary Services

Through SECTION 1, H.3223 adds Article 5 to Chapter 69, Title 40 of the State Code to be entitled “Telehealth for Veterinary Services” that establishes standard regulations for licensed veterinarians via online communication.

SECTION 2 amends Section 40-69-20 to define and outline what “Veterinarian-client-patient relationship” means.

H.3254 – Physician Licensure

H.3254 amends Section 40-47-32(E) to add that an additional examination may be waived if the board determines that the applicant possesses a general medical knowledge to competently practice medicine by using education facts and experience of the applicant.

H.3842 – Medical Authorization of Handicap Placards

H.3842 adds to Section 40-45-285 to allow a physical therapist to declare a handicap or temporary handicap in order for their patient to apply for a handicapped placard.

H.4342 – Dental Licenses

H.4342 amends Section 40-15-175 to add that the State Board of Dentistry may waive the requirement for a restricted instructor’s license if the applicant has a full-time academic faculty appointment of an assistant professor or higher in a dental school accredited by the Commission on Dental Accreditation (CODA).

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This article will be updated with the results of the Senate Medical Affairs Subcommittee hearings. To watch the livestream, click HERE.

Article posted with permission from Palmetto State Watch Foundation