Texas Panel Proposes Changes To Calculate Value of Care Delivered by Charity Hospitals
A work group appointed by Texas legislators has proposed a standard for defining and calculating the cost of charity care provided by not-for-profit hospitals in the state in order to determine the actual value of such care, the Fort Worth Star-Telegram reports. The proposal does not call for the hospitals to increase the amount of charity care they provide, but seeks to clarify how state and federal indigent-care funding is spent. State Sen. Jane Nelson (R) in a statement said, "Our hospitals have become the de facto universal health plan for every uninsured person in this country," adding, "We need to be reimbursing our hospitals fairly for the uncompensated care they provide," but "we also have a responsibility to the taxpayer, which means more transparency and consistency is needed."
The draft, which will be reviewed by the Texas Health and Human Services Council on Thursday, states that available funding sources appear to offset most charity care and bad debt costs, according to the Star-Telegram, which received a copy of the group's report. However, the group found that it is difficult to understand how well the system is working and seeks to increase transparency and accountability for hospitals. Texas hospitals report as many as six different calculations for the amount of charity care they provide, some of which include inflated charges used by hospitals, rather than market rates, the Star-Telegram reports.
Among the recommendations included in the report is limiting reportable charity care to people with incomes no more than two times the federal poverty level. However, the Texas Hospital Association in a letter to Texas Health and Human Services Commission said that limit is "incorrect and not consistent with current state law." Charles Bailey, general counsel for the association, said that the report "won't replace or eliminate the current (law) unless there are statutory changes," adding that requiring an additional report from hospitals would contribute to the "potential for confusion and frustration" (Barbee, Fort Worth Star-Telegram, 1/26).
