By Rims Barber

There is a provision of the new Health Reform Law that will help sick Mississippians this year. Nonprofit hospitals will have to meet new indigent care requirements.

Mary Jo went to the hospital recently and was given a bill of over $15,000. She was uninsured and unable to pay more than about $20 per week. It would take her about 15 years to get out from under this debt. Many hospitals are established as private nonprofit entities, and are expected to give back charity care to the community in exchange for their tax-exempt status.

The new Health Reform Law, passed by Congress this year, The Patient Protection and Affordable Care Act, amended Section 501c(3) of the Internal Revenue Code. It now requires nonprofit hospitals to publish guidelines for financial assistance, explain who is eligible, and how a person can apply for assistance.

In order to qualify for nonprofit status, a hospital must:

• Develop written financial assistance policies
• Limit what they charge for services
• Observe fair billing and debt collection practices
• Conduct regular community needs assessments.

With the exception of the needs assessment, these requirements go into effect this year. The Secretary of the Treasury is charged with enforcing the new provisions and has authority to issue further guidance and regulations as needed to make sure they are correctly implemented. The hospitals will report to the I.R.S on their annual 990 forms.

The Mississippi Human Services Agenda wrote all the private nonprofit hospitals in Mississippi asking them how they intended to comply with this new requirement. Only three hospitals responded to our survey, and we were directed to their websites for specifics on their financial assistance/charity care policies.

The web-published sliding scale showed discounts from the hospital charges, based on income. Since most hospitals accept a discount from insurance companies of 30-40 percent as payment in full, we can see that the hospitals are using their sliding scale to grant some patients the same discount as they give insurance companies.

Two hospitals used this sliding scale:

% of Poverty $ for Family of 4 Discount from charges

Below poverty $22,050 100%
100 – 119% $26,240 100%
120 – 139% $30,650 90%
140 – 169% $37,265 80%
170 – 199% $43,880 70%
200 – 299% $62,930 40%

Persons would have to bring documents with them to verify their income when they enter the hospital and declare that they are uninsured.

A major religious nonprofit medical center recently released a policy that allows any uninsured patient who applies during the admission process to have their hospital charges discounted by at least 50 percent (regardless of income), and free care for those under 200 percent of the federal poverty level.

If all our state’s nonprofit hospitals would make the effort to obey the law, and let people know that they may be eligible for discounts on their hospital care (and how they can qualify for this benefit), we would be much better off. People should let their local nonprofit hospitals know that they expect them to follow the law and treat the needy with equity.
Barber is director of the Mississippi Human Services Agenda.
Copyright (C) 2010 by Mississippi Forum 8/10