More Jobs, More Freedom, Better Health

May 1, 2024

Felicity Ropp

Policy Analyst

This spring, there have been several bills moving through the General Assembly that would streamline licensing for healthcare professionals and ensure South Carolinians have more choices in healthcare.  

These healthcare freedom reforms are much needed here in South Carolina. Following last year’s repeal of the burdensome Certificate of Need (CON) statute that prevented healthcare from operating in the free market, there is more to be done to cut red tape and burdensome regulations for healthcare professionals and patients.

Here are several of the ideas on the table and their status as the legislative session draws to a close: 


The American Medical Association writes that, “Scope of practice refers to those activities that a person licensed to practice as a health professional is permitted to perform, which is increasingly determined by statutes enacted by state legislatures and by rules adopted by the appropriate licensing entity.” Or, as we put it in our 2023-24 Palmetto Freedom Agenda, South Carolina should “trust proven professionals” to do their jobs!

Back in 2019, the General Assembly did just this for physicians’ assistants (PAs), allowing them to provide more services and prescriptions. In our 2021 Palmetto Playbook, we called for further action expanding scope of practice for Nurse Practitioners (NPs), and that year, scope of practice expansions passed for both podiatrists and advanced practice registered nurses (APRNs).

Here are the Scope of Practice bills that could pass this spring:

H.3988 – Pharmacists and pharmacy technicians

This bill, sponsored by Representatives Davis, M.M. Smith, B.J. Cox, Pedalino, Forrest, Wheeler, Kirby and Guffey, expands the scope of practice for trained pharmacy technicians and pharmacy interns, which allows pharmacists to delegate more tasks to those pharmacists in training, under the supervision of a licensed pharmacist and with proper training and continuing education. Status: Conference Committee. Passed the House, and, after a lengthy debate and amendment process, passed the Senate during the last week of the legislative session. The bill now heads to a conference committee, made up of Senators Cromer, Martin, and Hutto and Representatives Davis, M.M. Smith, and W. Jones.

H.3877 – Anesthesiologists’ assistants

Sponsored by Representatives West, J. Moore, M.M. Smith, Atkinson, B.J. Cox, Gagnon, Hayes, Caskey and Chapman, this bill increases the number of anesthesiologists’ assistants that can be supervised by an anesthesiologist from two to four. It also removes the unnecessary requirement for anesthesiologists’ assistants to appear in person before the Board of Medical Examiners to receive their licensure. Status: passed the House and received a favorable committee report in the Senate on April 18. Died on the Senate floor calendar contested by Senators Gustafson and Hutto.

S.1074/H.5183 – Certified Medical Assistants

This bill, proposed by Senators Davis and Fanning, expands the scope of practice and clarifies licensing requirements for certified medical assistants (CMAs). The bill would allow physicians and physicians’ assistants to delegate more tasks to “unlicensed assistive personnel,” including recording information, non-clinical telemedicine tasks, collecting specimens, and point of care screening tests. Status: success! S.1074 passed the Senate and received a favorable report from the House Medical, Military, Public and Municipal Affairs Committee on April 25. On May 7, several Representatives requested debate on the bill, so it now sits on the House contested calendar. The House passed H.5183, an identical House version of the bill on March 24. The Senate took up H.5183 on May 8 and passed it unanimously. Now it goes to the Governor’s desk!


One problem that healthcare professionals often face when moving between states is that their licensing credentials from their previous state do not carry over state lines. This means that healthcare professionals are often left to fight through red tape to become licensed and offer medical services in South Carolina. In the recent past, military credentials and credentials of military spouses have been given the recognition they deserve.

Another way to eliminate barriers and incentivize more healthcare professionals to move to the Palmetto State is to enter into more interstate health compacts, which essentially are just agreements with other states to recognize the credentials of their health care professionals. This is a policy we called for in our 2023-24 Freedom Agenda, and there have been several bills proposed that enter South Carolina into such compact agreements for licensed professionals in the healthcare sector and beyond.

S.610 – Professional Counseling Compact

This bill by Senators Cromer, Shealy and Climer would allow South Carolina to recognize licenses for professional counselors from other states whose licensing guidelines meet requirements set out in this legislation. That just ensures that the licenses we recognize are up to par with South Carolina’s licensing standards. The bill aims to increase access to professional counseling services, support the spouses of relocating military personnel who may be practicing counselors, and better allow telehealth technology in counseling services. Status: success! Passed the Senate and received a favorable report with amendment from the House Labor, Commerce, and Industry Committee on April 24. House passed the bill as amended on May 1. The Senate concurred in the amendments, and now the bill heads to the Governor’s desk! 

S.778 / H.4365Social Work Interstate Compact Act

Each chamber of the General Assembly filed and passed their own version of this interstate compact agreement for social workers. The bills are functionally the same and aim to increase access to social work services (including with use of telehealth services), “reduce overly burdensome and duplicative requirements,” and “promote mobility and address workforce shortages…by providing for the mutual recognition of other member state licenses.” Unfortunately, it seems that both bills are stalled in the opposite chambers after being unanimously approved in their originating chamber. We hope the General Assembly will recognize how they both favor this legislation and fast-track one of these bills before the end of session. Status: S.778 passed the Senate and has been sitting in the House Medical, Military, Public and Municipal Affairs Committee since February 7. H.4365 passed the House and has been sitting in the Senate Labor, Commerce, and Industry committee since March 12. These bills unfortunately died in committee.


Just like we say about education options, healthcare is not “one size fits all.” Individuals have unique health needs that may require flexible delivery of health services like telehealth (signed into law earlier this year) or home visits. Or, in the case of pharmaceuticals, it may mean visiting a compounding pharmacy, which create custom medications to suit each patient’s needs. These bills protect and expand access to flexible healthcare options for South Carolinians.

S.858 – Acute care at home

Introduced by Senators Davis, Garrett, Kimbrell, Setzler and Malloy, S.858 relieves regulations on acute hospital care at home programs and services. Patients will find it easier to receive hospital services in their homes rather than being admitted, saving costs for both hospitals and patients. Most notably, this legislation exempts acute care hospitals from Certificate of Need requirements immediately, rather than when they are scheduled to sunset in 2027 (under the CON repeal legislation passed last year). Status: success! passed the Senate and received a favorable report with amendment from the House Medical, Military, Public and Municipal Affairs Committee April 25. Passed the House unanimously on May 7, and the Senate concurred in their amendments. Now it heads to the Governor’s desk!

H.3592 – Compounding Pharmacies

Authored by Representatives Hyde and Carter, H.3592 is an extensive bill that revises requirements for compounding pharmacies and removes burdensome codified regulation on their operations. Regulation will instead be promulgated by the Board of Pharmacy, where it can much more easily respond to changes in medical technology and best practices. This bill better allows compounding pharmacists to do their jobs. Status: success! Passed both chambers and enrolled, now awaiting the Governor’s signature. 

Repealing Certificate of Need (CON) was a huge step for healthcare freedom. But over the last two legislative sessions, the General Assembly has also been taking a number of smaller steps to make South Carolina a haven for healthcare jobs and healthcare services. These steps add up. For South Carolinians, it means more jobs, more freedom, and better health. We hope these reforms continue, and Palmetto Promise will be standing by with even more options for expanding healthcare freedom.