Hospitals Fail to Explain Aid
Available to Poor, Report Says
October 2, 2003
By RICHARD PÉREZ-PEÑA
Each year, New York's hospitals
receive $847 million from
Albany to offset the cost of caring for people who do
pay their bills - usually the poor and uninsured.
But most hospitals do a bad job of
explaining to patients
that such assistance exists and whether they qualify,
many of them make it hard for patients to apply,
to a report released yesterday by a nonprofit group.
The group, the Public Policy and
Education Fund, is an arm
of Citizen Action of New York, a liberal advocacy
organization. The report found in interviewing
70 hospitals around the state that only one-third
produce a written policy describing their
programs, that some others could describe the policy
verbally, and that others would not give any
Some of the written policies say who is eligible,
income, and what services are covered, but most do
some hospitals said that such decisions are made case
case, the report said.
In nearly every case, the group
reported, getting the
information was an ordeal requiring great
multiple calls over many days, bouncing from one
another, trying to find someone to answer simple
As the report makes clear, there is
no federal or state law
requiring hospitals to care for people who cannot
except for emergencies - though nearly all hospitals
York do so, to some degree.
For hospitals that have such
programs, no law sets
standards for who is eligible, what treatment is
or how the paperwork should be handled.
"If you're a consumer who's been sent
to collections and
your credit rating is getting ruined and you can't
sometimes the hospital will tell you it has a charity
program and sometimes it won't, and sometimes it'll
clear to you what the rules are, but usually it
said Richard Kirsch, executive director of Citizen
of New York.
Patricia J. Wang, senior vice
president of the Greater New
York Hospital Association, said she believed that the
report overstated the problem. Still, she said, she
not be surprised if practices differed widely by
or if, in some cases, hospitals did not explain their
policies well to their patients.
She said her group, which includes
nearly all the hospitals
in downstate New York, would take up the report's
with its members, because "we think that if there's a
communication problem, we need to fix that."
But, she added, "This report
evaluated hospitals against an
ideal that Citizen Action believes should exist."
In part, the group based its standard
on laws in a few
states, particularly Massachusetts, that require
to inform patients, in writing, of that state's
care program and to explain what that program does.
The report criticized hospitals for
sending bills to
patients even as they were processing their
for coverage by an indigent-care program. Ms. Wang
however, that the state required hospitals to be
about trying to collect on bills, or risk losing aid.
In New York, state law puts a
surcharge on every hospital
bill, and that money goes into a state-controlled
money is used primarily to reimburse hospitals for
for the poor, but to some extent it also helps them
compensate for people who simply do not pay their
even if they are able to do so. The state distributes
$847 million to the hospitals each year based on what
proportion of their bills go unpaid.
New York's hospitals say they have
$2.5 billion a year in
unpaid bills. The state says the actual cost to the
hospitals of providing that care is about $1.7
the charity care fund covers only half the total.