| For Immediate Release: Albany, New York March 21, 2008 |
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For More Information: Charlie Albanetti 518.465.4600 x 121 (w) 203.300.9154 (c) |
(for PDF of this release, click here)
Many New York Hospitals Fail to Follow New Law Protecting Hospital Patients from High Bills and Aggressive Collection
There was good news and bad news in a survey of whether New York hospitals are complying with a landmark law that took effect in 2007 to protect uninsured New Yorkers from high hospital bills. The survey by the Public Policy and Education Fund of New York found that many hospitals were voluntarily offering greater financial assistance than the law requires. However, the survey also found that the great majority of hospital policies had major areas where hospitals did not follow the law, with almost four-out-of-ten receiving an F or a D grade.
“While hospitals are continuing to collect $847 million in taxpayer dollars to provide financial assistance to those patients who need it most, patients are still not being provided the legally required protections from aggressive collections policies,” said Richard Kirsch, Executive Director of Citizen Action of New York. “This report card shows that although many hospitals have improved their policies regarding determination of eligibility and the amount of discount provided, hospitals still have a long way to go to be in full compliance with the new law.”
In releasing the report, Citizen Action urged the Legislature to enact new measures proposed in the Executive Budget that would provide financial incentives for hospitals to comply with the law. The Assembly has approved those measures but the State Senate Majority rejected them in their budget proposal.
The report analyzes 97 of the largest hospitals in all regions of New York. Better than one-out-of-three hospitals (35 hospitals; 36%) received a grade of A or B. About the same number (36 hospitals; 37%) received a D or an F. The statewide average, also received by 24 hospitals (25%), was a C.
The regional averages show Long Island, the Hudson Valley, and Western New York (Buffalo-area) to have the most compliant hospitals, with each region earning an average grade of B. Central New York (Syracuse-area) and the Capital District were the worst-scoring regions, earning average grades of D and F, respectively.
Hospitals did well on expanding income eligibility requirements for patients in need of financial assistance, with 42 out of 97 hospitals providing discounts to patients with incomes above the law’s required 300% of the Federal Poverty Level (FPL). The vast majority of hospitals, 82 out of 97, also extended their assistance programs to patients who had exhausted their insurance benefits, and 26 of those hospitals provided assistance to underinsured patients beyond what is required by law. Many hospitals, 40 out of 97, extended their geographic eligibility beyond those required by law.
The survey found that most hospitals were not complying with the law’s requirement that any patient with an income below 300% FPL be presumptively eligible for financial assistance, with 80 out of 97 hospitals failing. Many hospitals – 35 – neglected to inform patients about the methods by which they can appeal when financial assistance is denied. Most often, hospitals failed the “installments plans” and “billing and collections” categories because the financial assistance policies submitted were silent on these topics, the statewide average being an F for both these categories.
Some hospitals did not comply with other crucial provisions in the law. 17 hospitals considered all of a patient’s assets to determine eligibility, when only very specific assets are allowed to be considered. 57 hospitals did not comply with the legally required time frame to allow patients to submit an application.
“With 35 hospitals earning an A or B, it is clear that compliance with this law is very easy for hospitals,” said Kirsch. “Clearly, legal requirements about hospital’s policies aren’t enough. The Department of Health must strictly enforce this new law, and the legislature must act in the State Budget to create incentive for hospitals to comply.”
The report makes recommendations that the Department of Health: issue new guidelines for compliance to all hospitals; require all hospitals to resubmit their policies and procedures; and review those policies for compliance. The Attorney General’s Health Care Bureau should work with hospitals to obtain enforcement agreements with any hospital it finds to not be in compliance. Finally, the legislature should enact provisions included in the 2008-09 executive budget proposal that change the complicated accounting methods for distribution of the $847 million indigent care pool to link reimbursement to the patients who actually receive financial assistance.
“This study proves that the Executive Budget’s proposal to tie hospital charity care dollars to compliance with the Financial Assistance Law for the uninsured is the only way for the uninsured to get the care that they need and for taxpayers to get what we’re paying for,” said Elisabeth Benjamin, Director of Health Care Restructuring Initiatives at the Community Service Society, and member of the State’s Technical Advisory Committee for the Indigent Care Program.
The report analyzed data that the hospitals provided the New York State Department of Health in mid to late 2007. The submissions were applied to a 46 question report card divided into categories to determine compliance with the new law that requires all general hospitals in New York to have policies and procedures that restrict the charges hospitals are allowed to apply to low income and uninsured patients, regulate the methods by which hospitals can collect payment from patients, and require hospitals to inform all patients of the availability of financial assistance.
A summary table of the findings is below. Click here for the full report.
|
Region ?
Category ?
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Long Island |
New York City
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Hudson Valley
|
Capital District
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Central New York -Syracuse
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Western NY- Rochester
|
Western NY – Buffalo
|
Statewide Averages by Category |
|
Eligibility
|
B
|
B
|
A
|
B
|
B
|
B
|
A
|
B
|
|
Discount Amount
|
A
|
A
|
A
|
A
|
B
|
A
|
A
|
A
|
|
Notice to Patients
|
C
|
D
|
C
|
F
|
F
|
D
|
D
|
D
|
|
Application, Approval, Appeal
|
B
|
C
|
B
|
D
|
C
|
C
|
C
|
C
|
|
Installment Plans
|
A
|
F
|
F
|
F
|
F
|
F
|
F
|
F
|
|
Billing and Collections
|
D
|
F
|
F
|
F
|
F
|
F
|
F
|
F
|
|
Consistency in Submission
|
A
|
A
|
C
|
C
|
A
|
A
|
A
|
B
|
|
Regional Averages
|
B
|
C
|
B
|
F
|
D
|
C
|
B
|
C
|
|
Quantities and Percentages of Grades by Region
|
||||||||
|
Region ?
Grades ?
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Long Island |
New York City
|
Hudson Valley
|
Capital District
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Central New York -Syracuse
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Western NY- Rochester
|
Western NY – Buffalo
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Total
|
|
A
|
4
|
5
|
2
|
0
|
0
|
0
|
0
|
11 – 12%
|
|
B
|
2
|
7
|
6
|
1
|
1
|
2
|
5
|
24 – 25%
|
|
C
|
0
|
8
|
1
|
5
|
2
|
2
|
6
|
24 – 25%
|
|
D
|
3
|
4
|
3
|
2
|
4
|
1
|
2
|
19 – 20%
|
|
F
|
0
|
5
|
2
|
4
|
5
|
1
|
0
|
17 – 18%
|
|
Total # of Hospitals
|
9
|
29
|
14
|
12
|
12
|
6
|
13
|
95
|