S.C. Code Regs. § § 61-89.3

Current through Register Vol. 48, 12, December 27, 2024

Section 61-89.3 - Guidelines for charging enrolled and non-enrolled patients

(a) Pregnancy tests

Non-Enrolled: Charge actual cost of the test.

Enrolled: Sliding fee scale in the Family Planning Setting

Comment: Title X should not be paying for pregnancy tests done in general clinic or other clinic sites for non-enrolled patients. Tests should be purchased with other funds and charges made.

(b) Education material

Non-Enrolled: May charge actual cost

Enrolled: Free

Comment: Education materials are an important part of the service and should be provided free in most cases.

(c) Contraceptive Supplies

Non-Enrolled: Charge actual costs for non medical methods.

Enrolled: Sliding fee scale for all methods.

Comment: Medical methods may not be provided for non-enrolled.

(d) Non-contraceptive Supplies and Medication

Non-Enrolled: Charge actual cost or give a prescription.

Enrolled: Sliding fee scale.

(e) Family Planning Related "Problem Visits"

Non-Enrolled: We should not receive "problem visits"

Enrolled: Sliding fee scale (no charge for visits which are a continuation of a previous visit at which service could not be completed)

Comment: Some visits may require limited time or be at the request of the clinician. Such visits do not require a charge.

(f) Services required by Federal regulations

Non-Enrolled: None

Enrolled: Sliding fee scale.

Comment: If the patient is partial or full-pay and refuses to pay, services may be denied, except in an emergency. Refusal is implies if, after adequate time lapse, the client has not made a reasonable effort to pay the charges. See Section4(c)(c),

(g) Other personal health services

Non-Enrolled: Charge actual cost or clinic fee.

Enrolled: Sliding fee scale

Comments: Family Planning funds should not be used to purchase non-required personal health services. The staff needs to use judgment regarding the necessity of the service. If the client refuses to pay for the service, it may be denied or referral may be made to another program or another provider of service.

(h) Gynecological services, culposcopy, or cryosurgery not directly related to method use

Non-Enrolled: Charge actual cost

Enrolled: Charge actual cost

Comment: Efforts should be made to serve gynecological patients with resources other than family planning funds.

(i) Infertility services

Non-Enrolled: None. All infertility patients should be enrolled.

Enrolled: Sliding fee scale.

Comment: Usually counselling only.

(j) Sterilization

Non-Enrolled: Only provided below 150% Income Poverty

Enrolled: Only provided below 150% Income Poverty

S.C. Code Regs. § 61-89.3