Sacramento Bee Looks at Hospital Billing, Charity Care Legislation
The Sacramento Bee on Monday looked at two bills in the Legislature introduced to address allegations that hospitals "us[e] aggressive collection tactics that often drive patients into bankruptcy" (Rojas, Sacramento Bee, 7/5). A bill in the Senate (SB 379), sponsored by Sen. Deborah Ortiz (D-Sacramento), would require hospitals to disclose their charity care policies to the state and allow state regulators to establish rules guiding hospital billing policies for the uninsured (California Healthline, 1/28). The bill also would prohibit hospital bills from being sent to collection agencies for 150 days following treatment, and families with annual incomes that do not exceed 400% of the federal poverty level could not be billed at higher rates than Medi-Cal, Medicare or workers' compensation rates. In addition, hospitals would be prohibited from placing liens on patients' homes or using other "aggressive" collection practices, according to the Bee (Sacramento Bee, 7/6).
A similar Assembly bill (AB 232), sponsored by Assembly member Wilma Chan (D-Oakland), would limit the amount hospitals are permitted to charge patients that lack health insurance. It 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. In addition, the bill would require hospitals to notify patients of no-cost care options and limit the amount that they can charge low-income patients without health insurance (California Healthline, 4/15). Under the Assembly legislation, hospitals would not be allowed to send bills to collection agencies until at least 180 days after patients are discharged. The California Healthcare Association in February responded to the legislative proposals by establishing voluntary guidelines for hospitals to provide financial assistance for low-income patients without health insurance. Under the guidelines, the policies should include charity care, discounts and financial assistance and should be posted visibly throughout the hospital.
CHA spokesperson Jan Emerson criticized the legislation for "prescribing one-size-fits-all" remedies. She added, "Our job is not to be the financiers of health care. Our job is to be the providers of health care." According to Emerson, aides of Gov. Arnold Schwarzenegger (R) have said the governor would veto both measures, and the administration is "insisting" that the billing and collection guidelines be voluntary. According to Schwarzenegger spokesperson Ashley Snee, the governor "applauds the hospital industry for implementing voluntary guidelines that will mean medical attention, financial assistance, payment plans and charity care for those who are most in need." Health Access Executive Director Anthony Wright said a veto by the governor would indicate that it is "OK to price-gouge the uninsured." He added, "It's one thing to have his agencies say 'Let the voluntary guidelines work,' but what he's doing is vetoing protection for people getting sent into bankruptcy" (Sacramento Bee, 7/5).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.