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Financial Assistance Policy Transparency

Oregon hospitals will be required to implement new financial assistance policy and debt collection requirements as a result of a new law (HB 3076) that goes into effect January 1, 2020. This memo serves as an overview of the upcoming requirements and provides information about upcoming education opportunities and resources. This memo does not cover the community benefit spending floor program, information will be shared as we learn more in separate communications. Please share and forward this information within your organizations. 


HB 3076 - NEW LAW OVERVIEW

Some sections of the law apply to all licensed hospitals and/or affiliated clinics, and some sections apply to nonprofit hospitals and nonprofit affiliated clinics. This matrix provides a clear overview of applicability to facility type.


FINANCIAL ASSISTANCE POLICIES

  • Beginning in 2020, policies must adjust 100% of the patient’s responsibility for those under 200% FPL and implement any sliding scale adjustment up to 400% FPL. Adjustments occur after any payments as a result of coverage from commercial, public or other payer sources.
  • Beginning for services performed after 2021, the sliding scale must be, at a minimum, 75% for 201-300% FPL, 50% for 301-350% FPL and 25% for 251-400% FPL.
  • Policies must:
    • apply to nonprofit affiliated clinics;
    • cover all medically necessary services or supplies; and
    • be translated into each language spoken by the lesser of 1,000 people or 5% of service area.

PATIENT SCREENING

  • Upon request of a patient, a hospital or affiliated clinic must screen to determine eligibility for the hospital’s financial assistance policy or the state medical assistance program; and
  • Prior to transferring medical debt, a hospital or affiliated clinic must screen to determine if a patient qualifies for the 0 – 200% FPL assistance and must provide a copy of the application.

TRANSPARENCY

  • Policies must be posted in locations of hospitals and nonprofit clinics that are accessible to the public; and
  • Community Health Needs Assessments must be posted on the hospital’s website and display: identified health care needs of the community, a three-year strategy to address the health care needs, an annual progress to address these needs and public opportunities to weigh in.

INTEREST AND DEBT COLLECTION

  • Beginning in 2020, a hospital, nonprofit affiliated clinic or debt collector may not charge interest that exceeds a Federal Reserve System calculation (see bill for details) and may only increase interest up to the state’s legal rate of interest; and
  • May not collect medical debt from a patient’s child or family member that is not financially responsible (applies to all affiliated clinics).

HB 4020 UPDATE - UNIFORM APPLICATION

The new requirements above build upon HB 4020 which was passed in 2018. HB 4020 required hospitals to implement plan language standards, include notice of financial assistance on billing statements and maintain public displays informing patients of the financial assistance policy. HB 4020 also requires OAHHS submit a uniform financial assistance policy application to the Oregon Health Authority to be available for hospitals and the public. In 2018, OAHHS worked with members review a uniform application developed by the Washington State Hospital Association which can be found here. This will be the application that OAHHS submits to OHA before Jan. 1, 2020.

Please contact Rebecca Tiel, director of public policy at rtiel@oahhs.org or 503-479-6009 with questions.

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