S.C. Code § 44-6-1130
Amounts in the fund described in Section 44-6-1120 shall be expended exclusively for Medicaid payments to ambulance services and shall not be used to replace payment commitments between the ambulance services and the State. The expenditures shall be established by the department in a manner consistent with the requirements and conditions of federal financial participation under 42 U.S.C. Section 1396b(w) and 42 C.F.R. 433.68, including the prohibitions against hold harmless provisions as defined under 42 U.S.C. Section 1396b(w)(4) and 42 C.F.R. 433.68(f) and shall be made only under federally approved payment methods and consistent with federal funding requirements and all federal payment limits as determined by the Secretary of the U.S. Department of Health and Human Services. Federal financial participation shall be sought in a manner that achieves the maximum amount of federal revenue such that the assessment amount equals the state share of the qualifying Medicaid ambulance services payments under this article.
S.C. Code § 44-6-1130