Thursday, December 11, 2014

Hospital Charity Care Requirements

Several U.S. states offer charity care to patients who meet the requirements.


"Charity Care" is the term nonprofit hospitals use when they waive or reduce fees charged to patients with incomes too low to afford the full cost of hospital care. The Hill Burton Act of 1946 grants money to nonprofit hospitals to provide care. The requirements for providing charity care differ by state and are defined by a number of criteria.


Washington State


Washington's Department of Health requires hospitals to provide charity care to patients who cannot pay the full cost of care. The law defines eligibility for charity care: an individual whose income is less than 100% of the federal poverty level (FPL), or a family whose combined income is between 100% and 200% of the FPL are eligible for hospital charity care. Additionally, a patient must be ineligible for any kind of public health insurance. Under Washington's laws, reduced fees for hospital care for families are provided on a sliding scale, while individuals who qualify for charity care must be treated free of charge. A hospital must also notify a patient when he or she is eligible for any kind of charity care. In Washington, all documents and notices pertaining to charity care must be readily available and must be translated into languages other than English.


The 2010 federal poverty guidelines can be viewed at the site below:


https://www.cms.gov/MedicaidEligibility/downloads/POV10Combo.pdf


New Jersey


New Jersey allows patients free or reduced-cost hospital care for what it deems as necessary hospital care; any other expenses, such as fees for doctors or anesthesia, may not qualify as charity care. In order to qualify for charity care in New Jersey, a patient must either have no health insurance or partial coverage. At the same time, a patient must not qualify for any kind of public health insurance program and meet the state's income requirements. If a patient makes less than 200% of the Federal Poverty Level (FPL), he qualifies for free charity care. As the percentage of the FPL increases in 25% increments, the percentage of costs charged increases by 20%.


http://www.nj.gov/health/charitycare/factsheet_en.shtml#51


California


California also has laws mandating charity care in its hospitals for patients who do not possess enough insurance to pay the full bill and/or do not make enough money to cover the full cost. In California, as in Washington and New Jersey, a patient must earn only a certain percentage of the Federal Poverty Level (FPL) in order to qualify for free or discounted hospital care. In Sacramento hospitals, for example, patients whose combined income for a family of four who made between 200% and 350% of the FPL qualified for free hospital care.


View the chart at the site below:


http://sacramento.bizjournals.com/sacramento/stories/2009/01/12/focus1.html#


Visit the site below to view a larger list of coverage from different California hospitals:


http://www.nonprofithealthcare.org/resources/CA%20Hospital%20Systems-Charity%20Care%20Matrix.pdf