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Nice work by @brianmrosenthal. Hospital group run by Cuomo pal suing lots of patients. Northwell Health says it "has a financial-assistance program for low-income patients that is more generous than required by the government." Well... Some thoughts. 1/ https://www.nytimes.com/2021/01/05/nyregion/coronavirus-medical-debt-hospitals.html
Here is the IRS requirement for financial assistance. “Section 501(r)(4)... requires a tax-exempt hospital organization to establish a written financial assistance policy (FAP).”
That's it! Zero rules on how good it has to be. They just have to *have* an FAP. 2/
That's it! Zero rules on how good it has to be. They just have to *have* an FAP. 2/
So saying Northwell’s FAP is better than that required by the government is true, but also meaningless. Let’s look at Northwell’s FAP. The summary document says it gives financial assistance to families up to 500% of federal poverty guidelines. Sounds OK at first glance! 3/
For a family of four in 2020, 500% of poverty guidelines was income of $131,000. That would make many families eligible for Northwell’s financial assistance. A sign of hope if you find yourself with huge bills you can't pay. But wait! What is the "financial assistance"? 4/
The fine print shows Northwell offers free care only to families at or below 100% of FPL. That’s only $26,200 for a family of four! How does that compare to policies at other hospital organizations? 5/
A year ago we reviewed the crazy quilt of financial assistance among hosps represented on the board of the American Hospital Association. Giving free care only to families making 100% of poverty level or less would put Northwell at the *bottom* of this list. 6/
Some systems (Onslow Memorial, Providence St. Joseph) give free care to families making up to 300% or even 400% of poverty guidelines. (Scroll down to see table in the middle of this story.) 7/ https://khn.org/news/hospital-group-mum-as-members-pursue-patients-with-lawsuits-and-debt-collectors/
Northwell gives sliding discounts to families making up to 300% of FPG, or $78,600 for a family of 4. They would pay 35% of “amount generally billed”- what Northwell would be paid on behalf of insured patients getting the same care. Not a bad discount, by industry standards. 8/
But Northwell says families making from 301% to 500% FPL also get “financial assistance.” What about them? This table shows that such families have to pay *100%* of the amount generally billed. How is that financial assistance? It’s not! 9/
This is a game almost all hospitals play. It’s true that the amount generally billed is much less than hospitals’ gross charges, or the “chargemaster” rate. Health systems pretend they are doing you a favor by giving a discount off charges. They are not. 10/
Almost nobody pays gross charges, which are multiples of what what hospitals are paid by Medicare. Gross charges are a starting point for negotiating with insurance companies. 11/
“Letting” you pay “only” 100% of the amount generally billed - IOW the amount the hospital could expect to *normally* collect from private insurance - is not financial assistance! 12/
Wait -- there’s more. Northwell also has an *asset* test. They add 25% of the “unencumbered value” of family assets over $10k to your income to determine financial assistance. So even modest savings accumulated over years can make you ineligible for help. 13/
And Northwell continues to sue patients. Nonprofit hosps, supposed to benefit communities in return for tax exemption, are realizing that suing patients is not a community benefit! Yale New Haven stopped long ago. VCU Health stopped last year. -30- https://khn.org/news/medical-debt-vcu-health-halts-30-year-campaign-that-seized-patients-wages-put-liens-on-homes/
In case anybody is interested, here is Northwell's financial assistance policy. All nonprofit hospitals must publish these. https://www.northwell.edu/sites/northwell.edu/files/inline-files/Financial-Assistance-Policy_Final-2018.pdf
