by Charlotte Kaye, CCHI Policy Fellow
One year has passed since the implementation of Colorado’s SB12-134, the Hospital Payment Assistance Act (now known as the Hospital Payment Assistance Program or HPAP). This charity care focused bill is meant to ensure that uninsured Coloradans are able to access quality affordable health care when they need it without unpredictable costs. Sadly, medical bills are the number one cause for bankruptcy in the United States.
Charity care programs have the ability to lessen the financial burden of medical costs on uninsured patients who need care but struggle to afford it. CCHI worked to pass the Hospital Payment Assistance Act in 2012, and it’s time for the first year check-up.
There are three main provisions of the HPAP. First, it requires hospitals to make information on discount programs and charity care available in hospital waiting areas and on hospital websites, as well as in patients’ hospital bills. Second, hospitals must offer to screen uninsured patients for financial assistance or charity care programs offered by the hospital. The bill also requires hospitals to offer reasonable payment plans to uninsured patients and allow thirty days to pass after a missed payment before sending the patient to collections. Last, the bill limits the amount that low-income uninsured patients (an individual that makes $17,500 or less per year) will be required to pay on a hospital bill to not more than the lowest negotiated rate paid to the hospital by a private insurer.
So how well is the Hospital Payment Assistance Program working for Coloradans? CCHI staff reviewed websites and called hospitals around the state to inquire about their charity care programs. On the positive side, there are some hospitals that have made significant progress toward implementing the law and providing consumers with clear charity care information. We found examples of hospitals clearly linking to their financial assistance information on their websites, ranges of online information on eligibility and discounts available, and instances of downloadable, printable applications for financial assessment in clear, concise language in English and Spanish.
Yet while the law has made strides in transparency, hospitals can and should be doing more. HPAP requirements are not widely known among many front-line hospital staff nor is information provided in their waiting areas. The majority of hospitals that provide the financial assistance policy information on their websites often do not provide it in clear or concise language for the consumer. Only one-fifth of hospitals surveyed have complete information on how to apply for charity care. Over half do not widely publicize the complete information that is required under proposed federal regulations.
We saw a variety of implementation practices of HPAP. The spectrum ranged from widely publicized financial assistance programs on websites and in waiting rooms to no information anywhere on the website, in the waiting room, or even when speaking with the hospital’s financial offices. Unfortunately, the majority of the hospitals we looked at have incomplete, limited, or no information on their charity care programs. We still have a long way to go to make sure consumers have the information they need about charity care in Colorado hospitals, but we are on the right path. So, we wish you a happy first birthday Hospital Payment Assistance Program, with eyes toward more complete implementation for consumers!