Financial Assistance Policies

Question: Can we count as charity care the financial assistance we provide to persons who exceed income requirements of our state's financial assistance/charity care policies? The state says we must give charity care to persons up to 200 percent of the poverty line, but we offer charity care to persons up to 300 percent of poverty.

Recommendation: All financial assistance that is provided in accordance with the organization financial assistance policy can be reported at cost as financial assistance/charity care.

(Updated November 2015)

Question: Does financial assistance for retired religious (who are sponsors of the health care organization) count as charity care?

Recommendation: Financial assistance may count as charity care when the member of the religious congregation meets the organization's financial assistance policy criteria.

Question: How should we handle community care (financial assistance/charity care) applications for our patients who are 18 AND are still living at home with their parents? Is there an industry standard that says we should or should not take the parents' income into account? We are not able to share medical information with parents, does the same hold true for financial eligibility?

Recommendation: The proposed rules on financial assistance are silent on this issue and we are unaware of an industry standard. We recommend that each organization's financial assistance policy address this. Identifying health insurance programs for which the individual may be eligible is usually the first step in the financial assistance process. As you develop your hospital financial assistance policies, be sure to align with state Medicaid policies and be aware that Federal Poverty Guidelines, used by most hospitals to set eligibility, are based on number of people in the household. 

(Updated November 2015)

Please Take Note: The information provided does not constitute legal or tax advice. The material is provided for informational/educational purposes only. Please consult with counsel regarding your organization's particular circumstances.