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Prognosis good for patients without health insurance
BY RIDGELY OCHS
Newsday Staff Writer

March 30, 2006

"This is a very big breakthrough," said Assemb. Pete Grannis (D-Manhattan), chairman of the Assembly's insurance committee, who along with Sen. Kemp Hannon (R-Garden City) hammered out the budget provisions. "What is most shocking is that if you're poor and don't have health insurance you could be charged two, three, five times as much as someone with Medicaid.

Advocates have long complained that hospitals often charge uninsured patients, who are usually low- to middle-income, higher rates than patients who have private or government health insurance. The state provides $847 million a year to compensate hospitals for charity care or unpaid bills. But until now there have been few regulations on how hospitals offer free or discounted care for the 3 million uninsured New Yorkers.

A recent report by the nonprofit Citizen Action of New York, an activist group that focuses on issues including healthcare, said that on average hospitals in the state charge self-paying patients 2.3 times more than the hospitals reported was their actual cost of providing inpatient care. Long Island hospitals had the highest regional rate in the state, charging 2.7 times inpatient costs, the report found.

The new budget provisions require that hospitals charge uninsured patients with incomes at or below 100 percent of the federal poverty level (for one person, $9,800) "a nominal payment amount." The hospitals also must use a sliding fee scale for uninsured patients with incomes between 100 and 250 percent of the poverty level. And they must charge the uninsured with an income between 250 and 300 percent of the poverty level (for one person $24,500-$29,400) no more than what the largest group insurer -- such as Medicaid -- has negotiated with the hospital for the service.

The provisions also keep hospitals from forcing the sale of a person's home to pay for medical bills and from calling in a collection agency if the person has filed for financial aid.

They also require hospitals to make charity care policies clear to patients. And they must report to the state how many patients applied for financial help and the hospital's costs for providing the care.

"I think it fixes a certain outstanding obligation to try to let consumers know of the availability of charity care and tries to systematize the procedures," said Hannon, chairman of the Senate health committee. He predicted that the provisions would face few objections from Gov. George Pataki -- in part, he said, because they represent a consensus among advocates, hospitals and legislators.

John Sweeney, a spokesman for the state division of budget, would not comment on the legislature's budget provisions. Pataki has made some of the same recommendations in his executive budget proposal.

For Dr. Rose Guercia and Donna Kass, co-directors of the watchdog group Long Island Health Access Monitoring Project, the legislature's provisions are a major victory. In 2001, they published a report looking at charity care practices at Island hospitals and were instrumental in getting Nassau County in 2003 to pass a law requiring hospitals to inform patients about charity care and to report how many people got care.

Although Grannis said that initially hospital associations blocked the provisions, they eventually joined forces with lawmakers.

"It was the right thing to do and I am very pleased with the spirit with which it got accomplished," said Kevin Dahill, president of the Nassau-Suffolk Hospital Council.

Source: Newsday.com

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