Federal Hospital Charity Care Screening Mandates: Is Your Hospital Ready for the Change?

As a domino effect of regulatory changes sweeps across the United States, hospitals should brace for the wave. Recently, a federal bill, the “Strengthening Consumer Protections and Medical Debt Transparency Act,” was introduced by Senators Chris Murphy and Mike Braun, following the footsteps of states like Minnesota, Illinois, Oregon, and Washington. These states had already implemented legislation requiring hospitals to screen patients for financial assistance eligibility before debt collection is allowed. This new federal Act has been proposed with the goal of easing the burden of medical debt and promoting transparency in collection practices across the U.S. Its provisions include validating insurance coverage appeals, verifying patient eligibility for assistance prior to debt collection, dispensing itemized statements and even possible liability for non-compliance. For hospitals, these changes could pose a significant burden, threatening to considerably amplify administrative workload related to executing financial assistance programs.

As these legislative shifts send shockwaves, there emerges a crucial question: Is your hospital prepared to navigate this complex and evolving regulatory landscape? Read on to learn how hospitals can get ahead.

1. Proactive Preparedness is Key

Instead of viewing required financial assistance screening as a hurdle, hospitals should view this as an opportunity to improve the efficiency and effectiveness of their financial assistance programs, creating a smoother process both for themselves and the patients they serve.

  • Refresh and optimize your financial assistance policy (FAP): A clear, streamlined policy that articulates the qualifications required for discount eligibility is critical for a seamless transition. Everything used to assess financial assistance applications must be clearly outlined in your policy. This step not only minimizes confusion for patients but will also lower the number of questions your team will need to answer relating to patient eligibility.
  • Employ technology that streamlines the eligibility verification process: There is no reason to analyze applications from patients who don’t meet eligibility criteria. Technology exists that can fast-track eligible patients to applications and alleviate wasted workload on your internal teams.

2. Embrace a Digital, User-Friendly Approach to Charity Care Applications

Complex forms and requirements create barriers for both patients seeking assistance and staff managing the paperwork. Streamlining these applications—and making them available online—can alleviate confusion, lessen complexity and expedite the process.

3. Consider Outsourcing or Supplementing Application Processing

Make new regulations easier on your internal teams. Engage a partner with expertise in financial assistance policies (FAP), who can simplify and streamline the eligibility and application processes, ensuring a seamless experience for patients, and alleviating the pressure on hospitals’ internal resources.

Hospital financial assistance can be an important lifeline for eligible patients, especially those lower on the income spectrum who struggle most with the rising costs of healthcare. These underutilized yet mission-critical programs are now experiencing regulatory attention that could spell a colossal administrative burden for hospitals, especially if we continue to screen patients for financial assistance primarily with paper applications and manual document review.

Now is the time to update Financial Assistance policies and procedures to ensure efficiency and effectiveness of these imperative programs that support affordable access to care.  Hospitals should anticipate a significant influx of financial assistance applications with these new requirements, however, with strategic preparedness and the right partners, hospitals can turn this looming challenge into an opportunity for improved efficiency and patient experience.

Editor’s note:

About Breez Health

Breez Health simplifies patient-facing and internal financial assistance/charity care processes, empowering hospitals to drive organizational growth and affordability of care to vulnerable members of their communities. By unlocking revenue opportunities that were previously lost to bad debt, Breez simultaneously helps support the financial wellness of nonprofit hospitals.

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