News & Updates: October 2023

CON Repeal In the News

Governor McMaster celebrated CON Repeal with a ceremonial signing of the Healthcare Facility Licensure Act on October 3, 2023.

South Carolina Politicos Take Victory Lap On ‘Certificate Of Need’ Repeal

An assemblage of South Carolina lawmakers and lobbyists gathered in the rotunda of the S.C. State House this week to watch governor Henry McMaster ceremonially sign a long-overdue phaseout of the state’s “Certificate of Need” (CON) legislation. Read more.

South Carolina Loosens Rules on Hospital Expansions, Services

State leaders believe a new law will make health care more accessible and affordable for South Carolinians. It repeals what’s known as the “Certificate of Need” process – something more than a dozen other states had already done. Read more.

Myrtle Beach Area to Get 3 New Hospitals, 1 Expansion with about 200 Beds Combined

A series of court settlements has cleared the way for three health care providers to build hospitals in Horry County. For more than two years, these hospital projects have been tied up in court as each provider pursued what’s known as a certificate of need, or CON, from the state. Read more.

Health Care Options will Multiply Across the Lowcountry with Deregulation

From Kiawah and James islands to North Charleston and Nexton, new clinics and free-standing emergency departments will open soon. Read more.

Tricks or Treats from CMS & HHS?

New or Updated CMS Provider Resources

  • Medicare Provider Compliance Tips: Click here to access.


  • CMS Health Information Handler Helps You Submit Medical Review Documentation Electronically.

Learn about the CMS Health Information Handler, a free service to help you upload and submit your medical documentation electronically to your Medicare Administrative Contractor.


  • Discarded Drugs & Biologicals: Updated JW and JZ Modifier FAQs for additional clarity on billing with these modifiers (see FAQs 7, 8, and 18–22).

CMS posted a new list of billing and payment codes only used for single-dose containers that may require the modifiers, depending on the setting.


  • Complying with Medical Record Documentation Requirements: Revised Guidance.

Learn what’s changed, including examples of documentation you can provide to support your Medicare claims.


  • Provider Compliance Focus Group Meeting: Thursday, November 2 from 1–3:30 pm ET.

Register for this meeting to let CMS know how to improve our processes and eliminate unnecessary requirements for medical review and prior authorization?


  • Help CMS Improve Provider Resources — Respond by November 9.

CMS is conducting a study to help us improve your experience with Medicare program and billing resources. Share your thoughts with us by taking this survey by November 9. 

Relevant Patient Resource

HHS Activity

On March 1, 2023, the Drug Enforcement Administration (DEA), in concert with the Department of Health and Human Services (HHS), promulgated two notices of proposed rulemakings (NPRMs) soliciting comments on proposals to allow for prescribing of controlled medications pursuant to the practice of telemedicine in instances where the prescribing practitioner has never conducted an in-person medical evaluation of the patient. On May 10, 2023, following initial review of the comments received, DEA, jointly with HHS, issued a temporary rule (First Temporary Rule) extending certain exceptions granted to existing DEA regulations in March 2020 as a result of the COVID–19 Public Health Emergency (COVID–19 PHE). These exceptions were granted in order to avoid lapses in care for patients. In particular, with respect to practitioner-patient relationships formed after the May 11, 2023, expiration of the COVID– 19 PHE, the First Temporary Rule extended the temporary exceptions until November 11, 2023. In this second temporary rule, as DEA and HHS continue to consider revisions to the proposed rules set forth in the March 1, 2023, NPRMs and in light of Telemedicine Listening Sessions that DEA hosted on September 12 and 13, 2023, DEA and HHS are further extending such exceptions to existing DEA regulations for new practitioner-patient relationships through December 31, 2024.


  • No Surprises Act’s Federal Independent Dispute Resolution (IDR) Proposed Rule released October 27, 2023.

If finalized, the proposed rule will improve communications between payers, providers, and certified IDR entities who make payment determinations; adjust Federal IDR timelines; establish new batching criteria; create a more efficient Federal IDR process; and change the administrative fee structure to improve accessibility of the process. 

               Link to the Fact Sheet

               Link the Proposed Rule


  • OCR Issues Resources for Providers & Patients re: Telehealth Privacy & Security of PHI:

“Educating Patients about Privacy and Security Risks to Protected Health Information when Using Remote Communication Technologies for Telehealth.” Although health care providers are not required by the HIPAA Rules to provide this education, the resource supports the continued and increased use of telehealth by providing information to help health care providers who choose to discuss telehealth privacy and security with patients.

“Telehealth Privacy and Security Tips for Patients” recommends measures patients can implement to protect and secure their health information. 

Articles of Interest

5 Ways to Build Physician-Administrator Trust, Boost Well-Being

Content via the American Medical Association:

Physicians can often feel like administrators think of them as production-line workers and that administrators don’t understand the challenges doctors encounter taking care of patients.


On the flip side, it’s not uncommon for administrators to believe that physicians don’t understand the challenges those in the C-suite face in running a hospital or health system, including the financial pieces required to ensure long-term viability. Click here to read from the AMA.

Attract and Keep Exceptional Talent with Retention and Recruiting Strategies for Today’s Labor Market

Content via Medical Economics

Providing high-quality patient care is vital to the success of a practice, but it can also be challenging to execute when physicians have a revolving door of staff or an understaffed office that struggles to keep up with the practice’s demands. Physicians and health care providers can implement recruiting and retention strategies aimed at improving how they find, recruit and retain exceptional talent. Click here to continue reading.


Want to dive deeper? Replay our October webinar, Why Your Approach to Employee Benefits May Be Disjointed. Access the recording in the webinar archive.

Hospitals, Doctors Drop Private Medicare Plans Over Payment Disputes

Content via USA Today:

For years, hospitals, doctors and health insurance companies have squared off over how much to pay for medical services. Insurers negotiate contracts with hospitals and doctors so their customers can get lower, in-network rates at those facilities. These negotiations, usually hammered out behind the scenes, are becoming increasingly tense and public as hospitals seek adequate payments and health insurance companies attempt to check spiraling medical bills. To continue reading, click here.

Registration Open: 2024 Annual Meeting

2024 SCOA Annual Meeting

August 1-3, 2024

The Sanctuary

Kiawah Island, SC

Join us next year along the pristine shores of Kiawah Island for the 2024 SCOA Annual Meeting. Reconnect with your peers as we seek clinical and professional excellence through dynamic keynotes, member talks and research presentations.

Keynote speakers for the 2023 Annual Meeting include Steven L. Frick, MD, and Milt Lowder, PhD.

Register early and secure your 2024 stay with our group rate! Meeting registration is required to receive the booking ID, which will be required to book in our group block.

Learn More & Register

Leadership Book Nook

The 6 Types of Working Genius 

by Patrick Lencioni

Subtitled, “A Better Way to Understand Your Gifts, Your Frustrations and Your Team,” Patrick Lencioni’s most recent leadership fable and corresponding Working Genius framework provide simple, yet gripping insight to transform your approach to work.


Lencioni proposes the vast majority of people possess 2 of 6 Working Geniuses, 2 of 6 Working Competencies, and 2 of 6 Working Frustrations. Working primarily within your Geniuses gives you energy and even joy. Working excessively in your Frustrations drains your energy and cultivates burnout.


Identifying your working geniuses and frustrations as well as those of your team and family members may blind you as the proverbial “lightbulbs” start going off in your brain. In classic Lencioni fashion, this newest book enlightens and inspires with an easy and quick read that is 100% worth your time.


Click here to watch an overview of the Working Genius Model.

Have a Book that was Meaningful to your Professional Journey? Please Share!

Please consider sharing a short paragraph about lessons learned from a book that has shaped you as a leader. Send your summary to Sarah Thompson.

Is Your Administrator a Member of SAOE?

SC Orthopaedic Practice Administrators, Ortho Service Line Directors, and emerging leaders in both private and hospital settings are encouraged to join the Southeastern Association of Orthopaedic Executives (SAOE). SAOE offers ortho practice leaders from South Carolina, Georgia, and Tennessee a unique opportunity to collaborate, network and learn from one another. SAOE membership and attendance at the annual meeting is an affordable and sound investment in your administrative team members.
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Thank You To Our Corporate Partner:
South Carolina Orthopaedic Association
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