Charity Care Compliance and The Amended Hospital Financial Assistance Law
12 January 2025
Below outlines a brief summary of the key rules for Charity Care Compliance, an overview of the amended Hospital Financial Assistance Law (HFAL) and the Office of the New York State Attorney General’s (OAG) role in ensuring charity care compliance.What is Charity Care?
Charity care, also referred to as financial assistance, offers free or discounted medical services to individuals unable to pay and meeting eligibility criteria. Charity care requirements are determined by a multitude of factors including federal laws & regulations, state laws and regulation, board policy and the mission of nonprofit hospitals.
The OAG’s Role
The OAG monitors the proper administration of charity care by nonprofit hospitals, ensuring access to health care, preventing deceptive practices, and educating the public on their rights under relevant laws.
Key Highlights of the Amended HFAL
Effective October 20, 2024, the amendments bring significant changes in the government’s desire to increase standardization to simplify hospital compliance and patient experience, expand patient eligibility and increase patient protections:
• All hospitals must use the NYS Uniform Financial Assistance Application.
• Financial assistance eligibility criteria include:
o Earnings up to 400% of the Federal Poverty Level (FPL).
o No consideration of assets or immigration status.
• Hospitals cannot initiate lawsuits for unpaid medical bills against patients earning up to 400% FPL.
- Hospitals may not sell patient debt to a third party unless the third party will relieve the debt and does not intend to pursue any collections. The hospital is responsible for determining that any debt buyer is doing so for the express purpose of absolving the debt.
- To initatie legal action agaist a patient, the CFO of the hospital mujst provide a signed attestation that the hospital has determined the patient's income to be equal or above 400% FPL.
Compliance in Action
Real-life scenarios illustrate the practical application of HFAL, from emergency room visits to billing processes. The amendments emphasize the importance of timely written notifications about financial assistance and the protection of underinsured patients.
Collaboration and Best Practices
The OAG collaborates with entities like Northwell Health, employing best practices to enhance compliance. Future sessions will delve deeper into IRS Community Benefit standards and compliance data.
Resources
For concerns or inquiries, contact:
• Charities Bureau: Website, 212-416-8400
• Health Care Bureau: Website, 1-800-428-9071
View the changes in detail