2026 South Carolina Legislative Session Recap
The 2026 South Carolina regular legislative session adjourned on May 14, and Governor Henry McMaster had a five-day action window for bills presented to his office. Any measures not signed or vetoed became law without his signature.
Immediately after the regular session adjourned, Gov. McMaster ordered a special session to begin on May 15 focused on congressional redistricting. The South Carolina Senate later adjourned without giving third reading to the redistricting bill, H. 5683, ending consideration of a new congressional map ahead of the 2026 election.
During the regular session, healthcare was a major topic, and the governor completed action on key measures, including bills addressing hospital emergency capacity, physician licensure, workers’ compensation fee schedules, nursing home tuberculosis screening, and pharmacist-physician collaborative practice agreements.
HCA Healthcare is providing this end of session recap to keep colleagues informed on key legislative developments that may affect care and access in the communities we serve.
Budget
The FY 2026-27 General Appropriations Bill, H. 5126, advanced through House and Senate action but remained unresolved in conference committee after the regular session adjourned. The House amended the Senate version on May 6, and conferees were appointed on May 7 to work out differences before the bill could go to Gov. McMaster.
Medicaid funding was a key concern during the budget process. The South Carolina Department of Health and Human Services (SCDHHS) requested $203 million in state dollars, while the House funded $175 million and the Senate $143 million, leaving advocates and hospitals urging lawmakers to fully fund the program and protect patient access to care.
Thank you to our HCA Healthcare colleagues for standing up for patients, hospitals, and the communities we serve by engaging in a Call to Action. Letting lawmakers hear your voices helps them understand what’s at stake. The budget remains in conference committee, where final Medicaid funding decisions will be made.
Expanding Access to Care
H. 3254, enacted as Act 103, authorizes the Board of Medical Examiners to waive certain additional exam requirements when the board determines that an applicant possesses the requisite general medical knowledge to competently practice medicine. The board must make findings of fact based on the applicant’s education and experience to make the determination. This flexibility is designed to help attract more physicians to South Carolina.
The bill passed the House 104-0 and the Senate 42-0. It was signed by Gov. McMaster and took effect on March 9.
S. 449, enacted as Act 166, authorizes pharmacists and physicians who are licensed, in good standing, actively practicing, and physically located in South Carolina to enter into Collaborative Practice Agreements (CPAs). These CPAs allow pharmacists to provide evidence-based medication management services and related patient care, including monitoring, education, and assessments, for specifically identified patients under the treating physician’s oversight. The pharmacist and physician must have access to the same electronic medical records system or HIPAA-compliant method for timely written communication.
The bill passed the Senate 44-0 and the House 108-0. It was signed by the governor on May 18 and took effect the same day, however, the CPAs may not be implemented until the State Board of Pharmacy and State Board of Medical Examiners issues effective regulations governing their use.
Hospital Operations
S. 958, enacted as Act 230, permits hospitals to place beds in hallways and corridors during a justified emergency if all other appropriate treatment areas are full and patient safety would be at risk. Hospitals must document the emergency, maintain records and report forms to the Department of Public Health at least quarterly, keep pathways and exits clear, remove beds when they are not in use during the emergency, and maintain written protocols.
The bill passed the Senate 37-0 and the House 113-0, and was signed into law by Gov. McMaster on May 19, and took effect the same day.
Workers’ Compensation Fee Schedule
H. 3874, enacted as Act 185, requires the South Carolina Workers’ Compensation Commission, in consultation with the cost containment committee, to establish medical fee schedules and related systems for workers’ compensation cases. The commission must strive to ensure access to quality medical care for injured workers while controlling prices and system costs. It also requires the commission to review the fee schedules annually, consider factors such as the medical consumer price index and workers’ compensation fee schedules in other states in the region, and hold a public hearing before finalizing annual fee schedule updates.
The bill passed the Senate 45-0 and the House concurred in the Senate amendment 115-0. It was signed into law and took effect on May 18.
Public Health Screening
S. 819, enacted as Act 174, establishes tuberculosis (TB) screening procedures for applications and new employees at nursing homes and community residential care facilities before they have resident contact. Facilities must conduct an annual TB risk assessment using CDC guidelines and obtain documentation from an authorized healthcare provider that the applicant has received a negative test and shows no sign or symptoms of active TB. Applicants with a positive test result or TB symptoms must undergo a chest radiograph and may be excluded from work until cleared, if tuberculosis disease cannot be ruled out.
The bill passed the Senate 39-0 and the House 112-0. It was signed and took effect on May 18.
Helping Alleviate Lawful Obstruction (HALO) Act
The HALO Act, H. 4763, sought to create a misdemeanor penalty for individuals who willfully impede, interfere with, threaten, or attempt to harm or harass first responders and emergency medical care providers after receiving a verbal warning. The bill was part of broader efforts to strengthen protections for first responders and healthcare workers.
The bill passed the House 95-18 and the Senate 44-0, but the House did not concur in the Senate amendment. A conference committee was appointed on May 14, and the bill remained in conference committee rather than receiving final enactment.
HCA Healthcare colleagues also engaged in a Call to Action on workplace violence during the session, encouraging lawmakers to support the HALO Act. Thank you for raising your voice. While the bill did not become law this session, your advocacy helped elevate this important issue and reinforced the need to protect our hardworking colleagues in healthcare settings.
