NC treasurer pushes for charitable patient care in legislation

Passing legislation requiring North Carolina hospitals to provide minimum levels of free or reduced-cost care to low- and middle-income residents not covered by insurance and offer generous reimbursement options is the “moral thing to do,” State Treasurer Dale Folwell said Tuesday.

A bipartisan measure, which was discussed but not voted on by the House Banking Committee, is in part a response to a 2021 study for the state employee health plan that Folwell’s charity care agency oversees. .

“This is a pro-consumer, anti-poverty bill, and it’s time we got together and moved on in the name of the invisible people, not the million-dollar (hospital) leaders. dollars,” Folwell, a Republican, told the panel. The odds of the bill advancing through this year’s session appear dim given the dwindling number of weeks remaining in Raleigh and the complexity of the measure.

The 2021 report, brought together with Johns Hopkins University, found that the majority of the state’s largest nonprofit hospital systems do not provide charitable care to uninsured or underinsured people who are approaching relief. federal, state and local taxes they receive.

The result is that patients can’t afford the expensive services they’ve received, leading to cycles of medical debt that “weaponize” their credit scores and ability to succeed, said Folwell, a former member of the Chamber and Treasurer since 2017.

The measure would require hospitals, clinics and certain other health care providers to adopt medical debt mitigation policies and screen patients before demanding payment to help them find insurance or credit options. ‘assistance.

Free and discounted care for amounts not covered by insurance would be on a sliding scale of up to 600% of federal poverty levels. If a debt is incurred, the hospital cannot charge interest and must cap monthly payments. The legislation also requires disclosure of health care service charges and Medicare reimbursement rates.

The North Carolina State Employees Association and the North Carolina Coalition Against Sexual Assault defended the bill, which would also allow the state attorney general and citizens to sue for damages. if the requirements are not met.

The North Carolina Health Care Association, which represents for-profit and nonprofit hospitals, did not take a position on the bill, spokeswoman Cynthia Charles said in an emailed statement.

Charles said the federal law already addresses several of the bill’s requirements, and the 2013 General Assembly legislation addresses many billing and collection practice issues. She explained the many ways hospitals and healthcare systems help consumers meet their financial obligations.

“To suggest that hospitals ‘weaponize’ medical debt is nothing but political grandstanding,” she wrote. “Hospitals are doing more than any other part of healthcare to help vulnerable patients.”

The legislative sponsors of the measure appear to be struggling to fight before legislation can advance this session, which is already expected to end around July 1.

“At this time, this bill, in my humble opinion, is not ready for prime time,” said Rep. John Szoka, a Cumberland County Republican and committee member, adding that he had several concerns. Szoka said he was ready to work with sponsors and Folwell’s office to rework it.

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