Minnesota, by simply removing the burden from the patient to the facility to establish eligibility under its financial assistance policy, is the market equivalent of Julius Caesar crossing the Rubicon.
(Deep Thoughts by Jack Handy): Minnesota Hospitals Barred From Debt Collection Until Screening Patients For Charity Care
Minnesota hospitals can no longer pursue collection activities on overdue bills until they first screen patients for charity care that could reduce or eliminate their debts.
The requirement took effect Nov. 1 as a result of state legislation. Lawmakers were prompted to act this year by reports that hospitals were suing patients for debts that were eligible for discounts or write-offs.
Minnesota, by simply removing the burden from the patient to the facility to establish eligibility under its financial assistance policy, is the market equivalent of Julius Caesar crossing the Rubicon. Consider:
1.No fear mongering. The facility cannot balance bill what they cannot legally collect. A family of four that earns<$120,000 (AGI) is 400% of the FPL. This is roughly 84.95% of the US. Almost everybody qualifies for some sort of financial assistance.
2. No cost shifting to employees. Almost everybody qualifies for some sort of financial assistance;
3.Potential to eradicate stop loss lasers. Almost everybody qualifies for some sort of financial assistance;
4. Texas has a similar provision in its Hospital District statute that requires the facility to first ascertain ability to pay BEFORE any collection activity; HEALTH AND SAFETY CODE CHAPTER 286. HOSPITAL DISTRICTS CREATED BY VOTER APPROVAL (texas.gov);
5. Financial assistance is a better alternative than the No Surprises Act. Financial assistance encompasses ALL services and not just ER and OON providers rendering services at an in-network facility;
6. Prospective direct contracting: if a group’s census shows that 75%, as an example, would qualify for financial assistance under the applicable FAP, I would approach the facility with a direct contract at the AGB percentage and if you cannot secure a satisfactory arrangement, simply RBR the facility. You cannot balance bill what can appropriately be transferred back to the facility via financial assistance i.e. “The Charlie Bown lump of coal.”
7. Downstream plan savings: if services are excluded for whatever reason, ( alcohol as an example) and treated as a non-Covered Benefit (i.e. member responsibility), all services related to that exclusion (assuming the member qualifies for financial assistance) are the facility’s risk in perpetuity because the claims will not be paid by the plan. It is like being first in line at the Golden Corral all you can eat buffet for all medically necessary and emergency services;
8. Financial Assistance is a growth market; There is nothing wrong with assisting not for profit hospital’s fulfill their charitable endeavor.