Ditch the Pitch
As defined in South Carolina law, a Discount Medical Plan Organization (DMPO) includes companies that offer discount programs for all health care services. The definition of “health care services” includes, but is not limited to, physician care, inpatient care, hospital surgical services, emergency medical services, ambulance services, dental care services, vision care services, mental health care services, substance abuse services, chiropractic services, podiatric services, laboratory test services, the provision of medical equipment or supplies, and pharmaceutical supplies or prescriptions.
Neither discount medical plan organizations nor their marketing companies may market plans in South Carolina unless the DMPO has properly registered with the Department of Consumer Affairs and has paid the required fees. Only the DMPO, which has the direct contracts with health care providers or provider networks, is required to register. Marketing companies must be listed on the DMPO’s registration application in order to market discount plans.
In addition, per the terms of the new law, the following organizations are exempt from registration:
(1) a pharmacy holding a permit or a company that owns one or more pharmacies holding a permit issued pursuant to Title 40, Chapter 43, that offers prescription discounts only from pharmacies;
(2) a benefit or program offered by a health insurer, health care service contractor, or health maintenance organization regulated pursuant to Title 38. A health insurer, health care service contractor, or health maintenance organization regulated pursuant to Title 38 that offers a discount medical plan that is not offered in conjunction with a health insurance plan it administers shall provide the Department written notice of the name under which such a discount medical plan is offered and the telephone number and mailing address at which the plan can be contacted. The notice required by this subsection shall be provided to the Department within thirty (30) days of the initial offering of new medical discount plans in this State, and within ninety (90) days of the effective date of this Act for existing plans;
(3) an insured benefit administered by, or under contract with, the State of South Carolina; or
(4) a patient access program voluntarily sponsored by a pharmaceutical manufacturer, or a consortium of pharmaceutical manufacturers that provides free or discounted products directly to individuals either through a discount or direct shipment.
In addition, Medicare Part D discount only providers, as defined in South Carolina Code Section 37-17-20 (8) will not be required to register.