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 61-31.4.403 - Evaluation of Impact of Reduction of Completion
Current through Register Vol. 48, No. 9, September 27, 2024
In evaluating whether the reduction in competition is necessary to obtain the likely benefits, the Department shall consider, but is not limited to:
1) The availability of arrangements that:
2) The ease with which health care providers or health care purchasers may obtain contracts with other health plans;
3) The difficulty in establishing new competing health plans in the relevant geographic market, including the ability to offer services requiring a certificate of need or purchasing these services from another health care provider or health provider network; and
4) The sufficiency of the number or type of providers under contract with the health plan available to meet the needs of plan enrollees.
Additional Considerations:
The Department may consider other information or factors relevant to the purposes of the Health Care Cooperation Act and this regulation. The information or factors so considered shall be specifically stated in the staff decision. Should the Department consider other information or factors that are not published in these regulations, the Department will notify the applicant as soon as is reasonable practical and will provide them an opportunity to respond.
