Maryland Commission Urges Laws Ensuring, Expanding Hospitals’ Obligations to Provide Charity Care
Maryland state law should be changed to ensure state hospitals are meeting their obligation to offer no-cost care to low-income residents, according to a report released on Friday by the governor's commission charged with examining the debt collection practices of state hospitals, the Baltimore Sun reports. Gov. Martin O'Malley (D) ordered the Health Services Cost Review Commission to do an "immediate and thorough review" of how hospitals collect debt from low-income patients in response to a Sun series examining the issue. The state's rate-setting system for hospitals is designed to allow the facilities to cover the charity care costs through the rates charged to other patients, the Sun reports.
The 90-page report recommends that state law be changed to require hospitals to offer no-cost services to all state residents with incomes less than 200% of the federal poverty level; that written notice about the availability of financial assistance be provided to all patients; and that hospitals and their collection agencies be prohibited from adding interest and penalties to bills to uninsured patients before court judgments are entered against them. The report also states that regulators should collect additional information related to hospitals' handling of money recovered from unpaid bills.
The Maryland Hospital Association said all of its members, at minimum, offer no-cost care to patients with incomes below 150% of the poverty level. However, Robert Murray, the commission's executive director, said, "The state lacks any standards for credit and collection activities and hospitals' articulated policies are ambiguous and vary even more widely." Officials on Thursday said they could not calculate the number of additional residents who would be eligible for charity care if the recommendations are adopted, but the Sun reports that based on 2007 levels, about 90,000 uninsured, non-elderly residents would become eligible.
MHA said the report and bills proposed last week addressing debt collection "include a number of steps in the right direction to improve the billing and collection process for Marylanders." MHA President Carmela Coyle said, "Some of the recommendations parallel and strengthen guidelines previously adopted by the Maryland Hospital Association." Bills recently introduced in the state House and Senate would set the minimum income level for charity care eligibility at 150% of the poverty level (Drew, Baltimore Sun, 2/13).
