States, Hospitals Expand Automatic Enrollment in Charity Care
A Tradeoffs/KFF Health News explainer describes how hospitals use "presumptive eligibility" to automatically screen patients for charity care and wipe out medical bills without requiring a formal application. Nonprofit hospitals increasingly use this approach to comply with ACA requirements to identify financial-assistance-eligible patients before pursuing debt collection, with screening rates rising from about 70% to nearly 90% of tax-exempt hospitals since 2016. Six states, California, Delaware, Illinois, Maryland, North Carolina, and Oregon, mandate presumptive eligibility for certain patient groups, though criteria vary widely and remain difficult for patients to find. For-profit and public hospitals are not subject to the federal reporting requirement, leaving gaps in who benefits from automatic debt relief.
State Medicaid agencies and hospitals must track how charity-care auto-enrollment policies interact with Medicaid eligibility and uncompensated care costs, since many low-income patients who qualify for assistance may also be Medicaid-eligible or recently disenrolled.
Finance
You might also like