S.C. Code Regs. § 19-820

Current through Register Vol. 48, No. 07, July 26, 2024

Section 19-820 - Penalties for Failure to Meet Requirements

A. Pursuant to South Carolina Code Section 44-6-170G, the Office may assess a civil fine for failure to comply with these regulations.

B. Failure to provide one record for each discharge (including newborns) according to R.19.810D or meet quality and item-completeness standards set forth in R.19.810E and R.19.910F.

(1) First occurrence: the Office of Research and Statistics shall notify the hospital Chief Executive Officer by certified letter of failure to comply. The hospital Chief Executive Officer shall reply in writing as to the reasons for non-compliance and provide a summary of measures implemented to insure future compliance. Full compliance shall occur within two subsequent monthly submissions;

(2) Subsequent occurrences: Fines may be followed as in subsection C. (2) below.

C. Failure to meet time frames for submission of required medical record extract information and supporting summary utilization data according to R.19.810D and R.19-810H or required financial and utilization items according to R.19.801A.

(1) The Office of Research and Statistics shall notify the hospital Chief Executive Officer by certified letter of failure to comply. The hospital shall be granted a two week grace period beginning on the date of the receipt of the letter.

(2) If the hospital fails to comply within the grace period:

(a) The Office of Research and Statistics shall notify the hospital Chief Executive Officer by certified letter of failure to comply. The Chief Executive Officer shall respond in writing to the Office of Research and Statistics within one week of date of receipt as to reasons for non-compliance.

(b) The Office of Research and Statistics may extend the grace period if it deems it warranted (as demonstrated by a good faith effort on the part of the hospital to comply) and shall notify the Chief Executive Officer in writing.

(c) Hospitals failing to comply within the grace period(s) may be fined as follows and the total fine may not exceed ten thousand dollars:

(i) First Occurrence $ 100

(ii) Second Occurrence $1,000

(iii) Third Occurrence $5,000

(d) A six-month grace period from the date these regulations become effective shall be granted by the Office of Research and Statistics before R.19.820 is enforced.

(e) The fines as levied as in C(2)(c) above shall be reset to "first occurrence" levels beginning three years from the date of first occurrence or upon change of ownership of the hospital or upon change of the hospital's Chief Executive Officer.

D. The proposed penalties become the final agency decision within ten days after the certified letter to the administrator unless the Chief Executive Officer requests a reconsideration of the penalty in writing within the ten day grace period from the Executive Director of the Budget and Control Board or his/her designee. When such a request is submitted:

(1) The burden of proof for contested penalties will be upon the hospital; and

(2) The Executive Director of the Budget and Control Board or his/her designee must respond by certified letter to the Chief Executive Officer's request within thirty days from the receipt of the request.

S.C. Code Regs. 19-820

Amended by State Register Volume 19, Issue No. 7, eff July 28, 1995; State Register Volume 29, Issue No. 6, eff June 24, 2005; State Register Volume 32, Issue No. 4, eff April 25, 2008.