Hospital Voluntary Pledge Billing to the Uninsured

These proposals are meant to supplement existing charity care policies, and not intended as a replacement. There are currently requirements in law already that govern notification, collection practices, and sliding scale discounts. These proposed standards would be added to the current requirements. We are also proposing minimum standards for hospitals and anticipate many hospitals will be able to offer broader policies.

Notification (applies to all patients):

• All hospitals will provide a written notice to all patients informing them about the availability of financial assistance.

Collection practices (applies to all patients):

• All hospitals will have their governing board or commissioners receive and review an annual summary report on collection actions taken.
• All hospitals have a written policy as to when and under whose authority an account is sent to collections.
• All hospitals have a written policy as to when a lien is placed on a primary residence.

Discounts (applies to the uninsured for medically necessary inpatient and outpatient services):

• No uninsured patient with income under 100 percent of the federal poverty level is required to pay for care. 1
• No uninsured patient with an annual income under 200 percent of the federal poverty level is required to pay more than the estimated cost of their care. (Cost
  is the charge times the hospital’s average cost-to-charge ratio.) 2
• No uninsured patient with an annual income under 300 percent of the federal poverty level is required to pay more than 130 percent of the estimated cost of their care. (Cost is the charge multiplied by the hospital’s average cost-to-charge ratio).2

 

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Note: Uninsured means no third party insurance. Health savings accounts are considered insurance.

¹ Income for those under 100 percent of poverty includes both earned and unearned income, but excludes assets. Income for those above 100 percent of poverty also may include assets.

² Cost-to-charge ratios are based on the previous year’s Year End Reports filed with the Washington State Department of Health.