By Doug Aldeen
The state of Minnesota recently enacted a comprehensive bill (effective November 1, 2023) that puts in place a charity care model that the rest of the US can follow.
1. A not-for-profit facility is prohibited from engaging in any “extraordinary collection actions” without first determining eligibility under the applicable financial assistance policy. The Texas Hospital District statute also provides for this as well;
2. “ Uninsured service or treatment” means any service or treatment that is not covered by: (1) a health plan, contract, or policy that provides health coverage to a patient; or (2) any other type of insurance coverage, including but not limited to no-fault automobile coverage, workers’ compensation coverage, or liability coverage. Think of the opportunities to transfer the risk back to the facility… . ;
3. The most a facility can charge for families with household income <$125,000 (AGI) is the rate that the facility charges its “most favored” insurance carrier. This bucket of individuals constitutes roughly 87% of the US.
4. Nobody needs traditional health insurance with household AGI <$125,000: A simple indemnity plan should suffice coupled with an all you can eat buffet of all emergency and medically necessary care and limited to zero medical debt;
5.Facility’s cannot turn individuals away because there is an outstanding medical debt nor can the facility attempt to establish a payment plan or demand a credit card payment without first ascertaining eligibility under the applicable FAP;
6. Mayo Clinic is in your backyard.