Free hospital care in MD for those under 1.5 times poverty guideline

[Waiting For Everyman]

State sets new rules on free, low-cost health care
The Baltimore Sun
By James Drew
May 8, 2009

Maryland hospitals must use new standards to determine who is eligible for free and reduced-price care, and provide information about financial assistance to all patients under two bills signed into law Thursday by Gov. Martin O'Malley.

The new rules, which take effect June 1, require hospitals to give free care to all Maryland residents with incomes less than 1.5 times the federal poverty guideline - equivalent to $33,075 for a family of four - and provide reduced-price care to low-income patients above that level.

Legislators approved the bills in response to stories published last December in The Baltimore Sun. The series documented how some of Maryland's 46 nonprofit hospitals were aggressively pursuing collection of unpaid bills from patients of limited means even though those debts are supposed to be recovered in the rates they charge.

The bills, sponsored by Del. Peter A. Hammen and Sen. George W. Della Jr., replace voluntary guidelines crafted by the Maryland Hospital Association for who is eligible for free care - referred to as charity care. Most hospitals have said they already follow those guidelines, according to state regulators.

...

The Sun's series found that in some cases, hospitals sought to add interest at the legal maximum of 12 percent a year on judgments, going back to 60 days after the patient was discharged. The Maryland Constitution sets interest rates at 6 percent for most debts, but hospital debts have been exempt.

...

The Sun reported last December that hospital debt-collection lawsuits spiked sharply between 2003 and 2006 before falling slightly in 2007. In all, hospitals filed more than 132,000 of these suits in the past five years, winning at least $100 million in judgments and placing liens on more than 8,000 homes.

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http://www.baltimoresun.com/news/local/politics/bal-md.hospitaldebt08may08,0,379784.story

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Eligibility for Medicaid will soon be expanded too, the story said.

Way to go, Baltimore Sun, Gov. O'Malley, and Md. Legislature. :applause: (I know from personal experience, the hospitals were pretending their "voluntary guidelines" didn't exist. They refused to ever lower the cost, even if 1) a qualified patient knew about the guidelines, 2) knew about the fee structure already compensating for those who couldn't pay, and 3) insisted the bill was unpayable - with proof. They were simply using this pretense of voluntary guidelines as an excuse to grossly jack-up all of their fees and then still aggressively collect those increased fees from the poor too! Sweet scam, huh? I guess the Gov. got a little steamed when he learned that.)

Congress should follow Md.'s example. Even if nothing else gets done right, the steps taken in Md. would help a lot if done nationally.

[napi21]

1. There's one big problem with that plan. Hospital care is THE

MOST EXPENSIVE CARE THERE IS! Do they have the same guidelines for GP's offices?Certainly not all, but the vast majority of poor people who go to the hospital for care have a problem that could be treated much easier and efficiently in a drs office.

I HOPE Obama & the congress can put together a HC system that will incorporate common sense, and provide the best treatment using the most efficient methods of care. Using the hospitals isn't it!

[Waiting For Everyman]

2. I agree. I'd like to see lots of good local community clinics built too.

Often poor people will self-treat until and unless something serious is going on. Obviously that isn't good. But I completely agree with you, you're right.

I don't think the poverty guidelines apply to individual private doctors' offices. That leaves a big hole in care, but maybe the soon-to-be-increased Medicaid eligibility will help provide for that.

Btw on the same track... now I have ChampVA which is VA insurance for families of disabled veterans. It covers any condition or illness, but nothing diagnostic or preventative at all. (No dental or vision either.) That's sort of the same thing... once you're ill you're covered, but until then you're screwed.