Note: This was sent to an electronic directory (that I maintain) of 936 Washington State (including border newspapers and radio and television stations in Idaho, Oregon, and British Columbia) Print and Broadcast Media. The result was that the number of people receiving free or reduced price health care increased 24% six months after the news release was mailed.

For immediate release.

Contact: Keith Gormezano... blah, blah, blah.

(USEFUL) NEWS RELEASE

SAVE THOUSANDS ON YOUR HOSPITAL BILLS!!!
LAW REQUIRES WASHINGTON HOSPITALS TO OFFER DISCOUNTS
BASED ON INCOME--BUT YOU HAVE TO ASK FOR IT
AS HOSPITALS AREN'T INFORMING PATIENTS OF THIS OPTION

            Having trouble paying your inpatient or outpatient hospital charges? Receiving calls and letters from your hospital's collection or financial services department "threatening to legal action unless you pay up and there's too much month left at the end of the money? Afraid that you won't be able to obtain emergency medical treatment because you do not have health insurance? Is your employer unable to provide health insurance for you, much less the rest of your family?

            A regulation from the Washington State Department of Health may spell relief for over a quarter or 27.5% of Washington State's population based on their income including many of the 550,000 residents according to the Washington State Health Care Commission without health insurance. And all you have to do to qualify is ...ask your hospital for reduced-fee care when you first come in, after you've been sent the bill and you're uninsured, or after your insurance has paid on it.

            According to Kevin Jones, an alumnus of Seattle University Law School and a Patient (Collections) Financial Representative for the University of Washington and Harborview Medical Centers in Seattle, a new provision of the Washington Administrative Code (WAC 246-453 also known as the Charity Care Act), 1991 WAC Supplement available in most public libraries requires all Washington State hospitals to reduce hospital bills based on the responsible party's income. Jones administers the regulation as part of his job duties and has written off as much as $62,000 in one day of reviewing patient accounts.

             The regulation was enacted as a trade-off when rate setting of hospital costs got axed, said Dave Smith, (1-800-321-2808 M-F 7:30-5:30 and ask to be transferred to 705-6000), director of the hospital and patient data in the state Department of Health in a November 25, 1992, Troubleshooter column in the Seattle Times.

            It does not guarantee that people will receive care or that hospitals are required to provide any specific care to a specific individual, Smith said. However, Jones said, according to a letter sent to him from Larry Hettick (206) 705-6014, Financial Analysis Supervisor, Hospital Data Systems state Department of Health, "outpatient care is (specifically) covered if hospitals chose to provide or offer the outpatient treatment". Some hospitals have informed patients that only inpatient care is covered.

            Under the regulation, a family making less than 200% of the federal poverty guidelines or for 1992-1993 would be $1135 a month for a family of 1, $1532 for 2, $1928 for 3, $2325 for 4, $2722 for 5, $3318 for 6, $3515 for 7, $3912 for 8, $4308 for 9, and $4705 a month for 10, is eligible for a partial or total reduction of their remaining in or outpatient hospital bill.

            This is even after Medicare or insurance has paid their portion, rejected the charges, or if there is no insurance or third-party coverage. "Unfortunately," Jones said, "doctor's bills are not covered... yet."

            The 1990 Federal Census Data and a new publication, 1992 Population Trends for Washington State recently released (9/92) by the state Office of Financial Management, Forecasting Division and available in most libraries, reports that 27.5% or over a quarter of the state's population is eligible for a full or partial reduction of their hospital bill under Charity Care Act guidelines. Those eligible for a full or partial discount must have an income below 200% of the federal poverty guidelines. Within those figures, 10.9% of the state's population is eligible for a complete discount because their income is below 100% of the federal poverty guidelines.

            Hospitals must also (1) cease collection efforts once a guarantor or patient has asked for a determination of their charity care eligibility; (2) refund any portion or all of the charges paid by the responsible party if that party is subsequently determined by the hospital to have met the charity care guidelines at the time services were provided and the amount paid is in excess of the charity care later given; (3) establish sliding scale reduced-fee care guidelines and make them available upon request; (4) offer payment plans over a reasonable period of time without interest or late charges on remaining balances after a charity care discount is awarded; and (5) not deny access to emergency care or transfer patients with emergency medical conditions or in active labor based on their lack of third-party coverage or the responsible party's ability to pay.

            But Jones believes the charity care requirement isn't well publicized by either the state Department of Health or local hospitals and should be to give people choices. He's putting his money where his mouth is spending over $300 of his own money earned as a state employee to publicize the program by mailing out news releases and preparing radio public service announcements for local Washington media.

            "In 1987," Jones stated, "I paid $941 to a collection agency for a bill which was eligible for 100% reduced-fee care because no one took the time to inform me of that hospital's charity care guidelines. I don't want it to happen to anyone else."

            In 1992, Washington's hospitals provided $108, 213,000, in reduced-fee care to low-income patients out of $5.4 billion in total charges or 2.00%. This was an increase of 24% from 1991. "Even If one subtracts medicare and medicaid payments which carry their own discounts", he noted, "Washington's hospitals still provided less than 4.3%, less than the interest rate on a savings account on charity care while 27.5% of the state was eligible.

            "Over a quarter of this state's population is eligible for a reduction in their bill and the state Department of Health and name of local hospitals from pages do nothing, nothing to promote it while parents take food money and pay charity-eligible medical bills." Smith agreed in the Seattle Times article that the charity care provision is not well publicized.

            "Hospitals say they post notices and train their staff to identify low-income patients but it isn't enough. You don't find information or a flyer about it on your bill, even at the hospitals I am employed by, much less on a collection letter," stated Jones. "While hospitals are required under the act to post notices about charity care in the admitting and emergency room areas, how many people read those notices? When you're bleeding from a car accident or your child has a temperature of 105o, you have other things on your mind.

            "With all their insufficient efforts, it's no wonder that Washington hospitals spent less than 2% of their total charges on charity care when twelve times that number or 27.5% of all Washingtonians are eligible for a discount on their hospital bills while 550,000 uninsured residents lie awake at night wondering, "what if". What the state Department of Health and name of local hospital from the attachment are doing is simply not enough."

            "If consumers can be educated how to cook beef and wash chicken properly," Jones commented, "then we can be educated about this program and how to apply. The total charity care given by each hospital should be reflective of the local or statewide economic condition and certainly should be not less than the current number of state residents below the 100% poverty line or 10.9%".

            "To start the ball rolling and inform patients and their responsible party of their financial rights," Jones exclaimed, "I encourage everyone who can't pay their hospital bill at name of local hospital from the attachment to call or write the applicable financial services department listed on your bill and ask for the discount you are legally entitled to under the law. If they give you grief, file a complaint with the State Department of Health in Olympia, WA 98504. Each violation can be a $100 a day in possible penalties.

            Among the top ten hospitals granting reduced-fee care in 1991, Swedish Hospital in Seattle, a privately-run, non-profit hospital was the second highest in total reduced-fee care by dollar amount. Harborview Medical Center of Seattle, ranked first in total care allocated 7.17% of its total charges and 19.88% of its adjusted revenues for reduced-fee care, and was the highest of all the hospitals in all categories. Adjusted percentages are after deducting medicare and medicaid payments which require hospitals to give additional discounts.

            Meanwhile, East Adams Rural Hospital and Garfield Memorial Hospital were ranked at the bottom by giving zero. "Apparently," Jones quipped, "there are no low-income people in the service area for East Adams and Garfield Memorial Hospitals, only millionaires."

            Locally, in 1992, name of local hospital provided $ (see attachment for amount of reduced-fee care) or % of total revenues and % of adjusted revenues. Name of local hospital was above/below the statewide average of $934,837, above/below the statewide median of $158,305, above/below the percentage of reduced-fee care on total charges, and above/below the percentage of adjusted charges after medicare and medicaid payments are subtracted.

            Remember, he said, there is nothing wrong with buying an item on sale, bargaining for a car, asking a merchant to lower his or her price, using a coupon to buy groceries or dinner, or asking name of local hospital for a reduction on your bill. All are as North American as Apple Pie.

            Unless you do, you won't save any money, stop those dunning letters and phone calls, or have peace of mind. You could even be assigned to a collection agency for "not paying your bill" and find it difficult in 5 years when times are better to get certain jobs or obtain a loan for a car, school, or a home.

            And always, always write down who you talked to and when, keep copies of any letters you send or forms you fill out, and ask your state representative or senator, state Department of Health (they work for us, remember, and your local hospital why this regulation is not well publicized".

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