discounts and/or a catastrophic medical episode discounts, you will probably end up with a lower bill than a very well insured person.
Legal Implication of Financial Aid and Insured Patients
Let’s suppose that you or the patient you represent has Medicare or any other type of insurance and you have clearly demonstrated that there is defnite fnancial hardship in the form of poverty or medical catastrophe.
From time to time, you may have an uneducated biller or manager try to tell you that they cannot provide fnancial assistance to an insured patient because it is against the law. This is not true. There may be another motive, but this cannot be the “end all” reason.
For some time, U.S. hospitals did not offer fnancial assistance to Medicare benefciaries that could not cover their cost-sharing liabilities (copays and deductibles) because they feared that the routine waiver of Medicare coinsurance and deductibles could violate a Federal law called the Anti- Kickback Statute10.
In February of 2004, the secretary of the Department of Health and Human Services dispatched a letter to the American Hospital Association to dispel this myth11:
Your letter suggests that HHS regulations require hospitals to bill all patients using the same schedule of charges and suggests that as a result, the uninsured are forced to pay “full price” for their care. That suggestion is not correct and certainly does not accurately refect my policy… the Offce of Inspector General have prepared summaries of our policy that hospitals can use to assist the uninsured and underinsured.
his guidance shows that hospitals can provide discounts to uninsured and underinsured patients who cannot afford their hospital bills and to Medicare benefciaries who cannot afford
- 10 Hospital Discounts Offered to Patients Who Cannot Afford to Pay Their Hospital Bills, Offce of the Inspector General, February 2, 2004.
- 11 Letter from HHS Secretary Tommy Thompson to AHA President Richard Davidson, February 19, 2004.