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Panel approves H.4067 to require at least one physician on duty at emergency departments, adds freestanding ED clarification
Summary
The subcommittee unanimously approved House Bill 4067 after adding an explicit reference to freestanding emergency departments. The bill would require hospitals and freestanding emergency departments operating emergency services to have at least one physician physically present during hours of operation; urgent cares are not covered.
Panel approves H.4067 to require at least one physician on duty at emergency departments, adds freestanding ED clarification
The South Carolina Senate Medical Affairs Subcommittee unanimously approved House Bill 4067 after inserting language to explicitly include freestanding emergency departments. The bill would require every hospital with an emergency department — and every freestanding emergency department, regardless of classification — to have at least one physician physically present during the department's hours of operation as a condition of licensing and relicensing.
Supporters told the committee the change is a safety‑preserving, largely technical clarification intended to lock in current practice and prevent future facilities from operating without on‑site physicians. Witnesses from the South Carolina College of Emergency Physicians and Prisma Health said South Carolina emergency departments already staff on‑site physicians and that the language will protect patients in rural and non‑trauma settings.
Lee Catherine (Catherine) Moore, a board‑certified emergency physician and president of the South Carolina College of Emergency Physicians, testified that while many South Carolinians already have physician coverage at emergency departments, the bill safeguards access: "Most people think I'm gonna go there and there's gonna be a physician who knows how to take care of me. And this is what this law would do, was just preserve that for every emergency department." Moore said the legislation does not apply to urgent care centers.
Lee Turner, a board‑certified emergency physician representing Prisma Health, told the committee free‑standing emergency departments and rural EDs sometimes create confusion for patients and that the bill eliminates a potential loophole by requiring on‑site physician coverage. Turner said workforce data and local residency programs supply physicians who commonly remain in the state.
Committee members asked about classification and the scope of the definition. The sponsor and witnesses told the panel the bill's language captures existing freestanding emergency departments and that urgent‑care clinics remain excluded. Senator Tedder proposed an oral clarification to insert "and every freestanding emergency department" after "every hospital in the state with an emergency department," and committee witnesses voiced support; the committee adopted that modification and subsequently approved the bill by voice vote. The transcript records the final vote as affirmative and unanimous, with Senators Brett Matthews, Martin, and Lieber identified among those recorded as voting aye.
Witnesses said the bill is modeled on language used in other states (sponsors referenced Indiana's model language) and that only a small number of states currently have comparable laws. The discussion also noted EMTALA — the federal Emergency Medical Treatment and Labor Act — which applies to emergency departments and requires a medical screening exam and stabilizing treatment regardless of ability to pay; committee testimony emphasized that urgent cares are not bound by EMTALA and are not included in this bill.
The subcommittee forwarded the amended H.4067 out of committee.
