New U.S. rules for collecting from uninsured patients don't concern region's hospitals

Under the proposed new rules, nonprofit hospitals would have to provide a "plain language summary" of financial assistance policies before patients are discharged. Patients would be given 240 days to submit a completed application for financial assistance.

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During those eight months, hospitals would be prohibited from reporting debts to collection agencies until they make a reasonable effort to determine whether patients are eligible for financial help.

— The federal government plans to crack down on how nonprofit hospitals collect money from uninsured patients, but the move isn't creating much concern among hospital system administrators in Southwest Florida.

Both the Lee Memorial Healthcare System and the NCH Healthcare System in Collier County say their policies conform to current laws and are similar to what the U.S. Treasury Department is proposing under a provision of the 2010 Affordable Care Act, which recently survived a Supreme Court ruling.

The government is considering new rules at a time when the Minnesota Attorney General's Office has a lawsuit pending against a Chicago-based collection agency, Accretive Health, for violating patient privacy and consumer protection laws.

Among other allegations, the complaint said the company had debt collectors working bedside in emergency rooms while patients were clearly in pain. The U.S. Senate held hearings over what transpired at some Minnesota hospitals.

Under the proposed new rules, nonprofit hospitals would have to provide a "plain language summary" of financial assistance policies before patients are discharged. Patients would be given 240 days to submit a completed application for financial assistance.

During those eight months, hospitals would be prohibited from reporting debts to collection agencies until they make a reasonable effort to determine whether patients are eligible for financial help.

Patients eligible for financial help cannot be charged more for hospital services than what is billed to insured patients.

Lastly, hospitals would be prohibited from engaging in any collection activity that interferes with the patient's treatment.

The rules apply to charitable hospitals, which could jeopardize their tax-exempt status if they don't comply. A 90-day comment period is under way now for hospitals to respond.

Lee Memorial spokeswoman Mary Briggs said the federal proposals don't seem onerous because the hospital system has been publishing its policies on its website for some time and they are available in writing to patients.

Emergency room patients will register unless their illness prevents it, Briggs said.

After a patient has been seen by a physician, someone from the business office will provide financial assistance forms if they don't have insurance. They also may ask if the patient wants to use a credit card for payment, but it's done with sensitivity in mind, she said.

"We are not stopping your care to get a credit card number," Briggs said.

She did, nonetheless, express concern if hospitals would have to wait 240 days before they could turn an unpaid bill over to collections. Lee Memorial had $147 million in bad debt last year and the cost of charity care provided was $39 million. Net revenue was $1 billion.

"The 240 days, that is new to us," she said. "Right now there are no limitations on applications. We don't have a policy that says you have to apply within a certain number of days. People who want to apply do it pretty quickly."

NCH officials likewise said the 240-day rule could exacerbate getting paid.

"The 240 rule will result in even longer delays regarding payment for services provided," Sandy Wood, director of revenue cycle, said in a statement. "Overall, hospitals experience a very low collection rate on self-pay balances and further delays create even greater financial stress on hospitals that continue to face decreasing reimbursement."

NCH's charity care, at a gross figure, was $71 million last year and its gross bad debt was $40 million, NCH spokeswoman Debbie Curry. Net revenue was $483 million last year.

Neither hospital system allows outside debt collectors to come on its campuses to seek money from patients.

"NCH adheres to all rules contained in the Fair Debt Collection Practices and has never allowed representatives from a collection agency to be physically present in the emergency department or any other location throughout our system," Wood said.

NCH provides financial forms to patients upon request and will help patients complete the forms, Wood said. For self-pay patients, a 40 percent discount is offered.

The American Hospital Association has had voluntary billing and collection guidelines since 2003 but they were updated recently due to the affordable care act.

© 2012 marconews.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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