Ready for prime time? Make your financial assistance policy a class act.
Today's regulatory climate makes it far from simple for hospitals to offer discounts to uninsured and indigent patients. Questions abound regarding whether offering such discounts might lead to reductions in Medicare payments for outliers, new technology, and bad debt. Offering waivers of coinsurance or deductibles may seem an attractive option, but routine waivers could implicate federal statutes regarding illegal remuneration and patient inducement. And across-the-board discounts to uninsured patients could change the calculation of a hospital's "usual charges," resulting in the hospital's violation of the statutory bar against having charges to Medicare that are "substantially in excess" of the "usual charges." The best course for hospitals is to have clearly defined financial assistance policies in place that reflect an awareness of all the related potential legal and regulatory concerns.
Barry
Dennis
D
Vinson an Elkins, LLP, Washington, DC, USA. dbarry@velaw.com
Keough
Christopher L
CL
D005377:Financial Management, Hospital / Q000331:legislation & jurisprudence; D005382:Financing, Personal; D017057:Medically Uninsured; D016134:Organizational Policy; D014481:United States