California Healthcare Association Introduces Voluntary Hospital Guidelines on Charges for the Uninsured

The California Healthcare Association on Wednesday presented to Gov. Arnold Schwarzenegger (R) voluntary guidelines for CHA members that would ease hospitals' collection policies and offer financial aid to low-income uninsured patients, the Los Angeles Times reports. According to the Times, "the most dramatic recommendation" would set hospital charges for patients with annual incomes at or below 300% of the federal poverty level at the rate paid by Medicare and other government-run programs, which could reduce hospital charges to some patients by thousands of dollars. Fred Harder, CHA vice president of policy, said that most hospitals currently employ policies that discount bills for low-income patients but added that the guidelines would "raise awareness of this publicly" and standardize procedures for hospital administrators and patients. Hospitals have been criticized by consumer advocacy groups for charging uninsured patients more than insured patients and for using "over-aggressive" methods, such as attaching liens to patients' homes and garnishing wages, to collect patient bills, the Times reports. CHA recommends that hospitals discontinue such practices. Officials from Catholic Healthcare West, which operates 37 hospitals in California, said the health system would adopt the guidelines by this summer.

Harder said that CHA had begun to discuss the voluntary guidelines after Assembly member Wilma Chan (D-Alameda) in February 2002 introduced a bill (AB 232) that would require hospitals to provide charity care or offer discounts in some cases to people whose annual incomes are as much as 700% of the federal poverty level (Richardson, Los Angeles Times, 2/12). The bill also would require hospitals to notify patients of free care options and limit the amount that hospitals can charge low-income patients without health insurance (California Healthline, 8/4/03). Gerald Kominski, an associate director of the University of California-Los Angeles Center for Health Policy Research, called the guidelines an "astute political move," adding, "This may be an effort on the part of the industry to try and preempt legislative action or legal remedies." However, Chan said that the guidelines would "not be enough" and added that "patients need dramatic relief from hospital bills," the Times reports (Los Angeles Times, 2/12).