South Carolina requires yearly reviews of work injury medical payments

South Carolina’s workers’ compensation commission must set a medical payment schedule and procedures to review charges and enforce the rules. The rules concern medical care for work injuries. The separate authority to set maximum payments for medical practitioners excludes hospital inpatient care, hospital outpatient care, and outpatient surgery centers. The commission must consult the cost containment committee. It must aim to preserve quality care and access to primary and specialist care while controlling prices and costs. The law took effect when the governor approved it on May 18, 2026.

The commission must review medical payment schedules each year and revise them when appropriate. The yearly review covers medical payment schedules adopted under this section and requires consultation with the cost containment committee. The review must consider the medical consumer price index, a measure of medical price changes, and payment schedules for work injuries in other states in the region. If the commission adopts adjustments to an existing medical practitioner payment schedule under this authority, it must do so annually.

The commission must hold a public hearing and consider comments with the cost containment committee before finalizing each annual update. The hearing receives comments from people and organizations affected by workers’ compensation medical payment rules. The commission chairman appoints the committee’s nine voting members. Two members represent each group: medical providers, workers’ compensation insurers, employers, and injured workers’ rights. The chairman or the chairman’s appointee holds the ninth seat.