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NY: Limiting Hospital Charges for Uninsured

It's bad enough that tens of millions of Americans have no health insurance; adding insult to injury is the fact that the uninsured, often the poorest folks showing up for treatment, are charged many times more than private insurers for the same medical treatments. In a breakthrough, the New York state budget this week included provisions to cap how much hospitals can charge low-income uninsured patients. Spearheaded by Assemblyman Pete Grannis, the new rules require:
  • Uninsured patients with incomes at or below 100 percent of the federal poverty level will be charged "a nominal payment amount."
  • Hospitals must use a sliding fee scale for uninsured patients with incomes between 100 and 250 percent of the poverty level.
  • The uninsured with incomes between 250 and 300 percent of the poverty level will be charged no more than what the largest group insurer - such as Medicaid - has negotiated with the hospital for the service.
  • Hospitals may not force the sale of a person's home to pay for medical bills .
  • Hospitals are more generally required to make the rules for charity care clearer to all patients. These legislative changes followed publication of a report by Citizen Action of New York and a 60 Minutes segment which both highlighted the disparity between charges imposed on the uninsured versus far lower bills to HMOs and insurance companies for the same procedures.