Committee advances patient-billing transparency bill after testimony from hospitals, insurers and consumer agency

The committee voted to report bill 4069, known as the patient-friendly billing measure, after hearing testimony from the South Carolina Hospital Association, Blue Cross Blue Shield, the Palmetto Promise Institute and the Department of Consumer Affairs. The bill would require providers to offer patients a clear, plain-language itemized bill (electronically or on paper) that shows the patient’s portion and allows patients to request the full, detailed billing document later.

Austin Smallwood of the South Carolina Hospital Association told the committee the association’s amendment aims to make initial bills more digestible while preserving a patient’s right to request the entire set of billing codes and detailed records. He said the proposal is intended to avoid overwhelming patients with voluminous code-level documents immediately after care and to allow a “couple page” summary that lists major services and supplies.

Balen Moore of Blue Cross Blue Shield said the insurer has no objection to the underlying bill but proposed language clarifying which provider–insurer communication document should be referenced (electronic remittance advice) so the statute aligns with federal requirements for remittance documentation. Moore said his amendment restores a billing-code reference for insurer–provider communications even if that code would not be in the patient-facing summary.

Orrin Smith of Palmetto Promise Institute and Carrie Lybarker of the Department of Consumer Affairs supported greater transparency. Lybarker told the committee the consumer agency reviewed roughly 900 medical-billing complaints since 2019 and identified lack of itemization, coding issues and overpayment as top problems; the agency recommended caution around any waiver provision and urged that patients be given the bill and the choice of electronic or paper delivery.

Committee members asked whether the summary bill would result in multiple bills and whether a patient’s initial waiver of a patient-facing bill would prevent later access to detailed records. Witnesses said the intent is that a concise, plain-language summary be provided first (and can be electronic via patient portal), and that patients retain the right to request the full, detailed billing and associated codes later.

The committee directed staff to reconcile the hospital association and Blue Cross amendments and prepare a comprehensive amendment for the next day. The committee then moved to report the bill favorably out of committee subject to those edits. The record shows a voice/hand vote to advance the bill; the transcript does not provide a full roll-call tally.