South Carolina Code of Regulations
Chapter 61 - DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
Subchapter 61-31 - Health Care Cooperative Agreements
Chapter 4 - CRITERIA FOR REVIEW
Section 61-31.4.402 - Evaluation of Benefits and Disadvantages

Universal Citation: SC Code Regs 61-31.4.402

Current through Register Vol. 48, No. 9, September 27, 2024

1. In evaluating the benefits likely to result from the cooperative agreement the Department shall consider, but is not limited to:

a) enhancement of the quality of health and health related care provided to South Carolina citizens;

b) preservation of health care providers close to communities traditionally served by those providers;

c) gains in the cost-efficiency of the services offered by health care providers or purchasers involved;

d) improvements in the use of health care provider resources and equipment;

e) avoidance or elimination or reduction of duplication of health care resources;

f) improvements in access to health care for citizens in the community;

g) support of the agreement by purchasers and payers in the health service area;

h) the extent of financial risk-sharing by the parties as a result of the agreement;

i) the provision or enhancement of health care services to Medicaid, indigent, or charity care patients by the parties to the agreement.

2. In evaluating the disadvantages likely to result from the agreement, the Department shall consider but is not limited to:

a) the likely adverse impact, if any, on the ability of the health care purchasers to negotiate optimal payment and service arrangements with the health care providers or health provider networks;

b) the extent of any reduction in competition among health care providers, purchasers, or other persons furnishing goods or services to or in competition with health care providers or purchasers that is likely to result directly or indirectly from the health care cooperative agreement;

c) the likely adverse impact, if any, on patients in the quality, availability, and price of health care services;

d) the extent to which the agreement may increase the costs of prices of health care at a hospital or other health care provider which is a party to the agreement;

e) the extent to which services to Medicaid, indigent, or charity care patients are adversely impacted by the agreement.

Disclaimer: These regulations may not be the most recent version. South Carolina may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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