More than 40 organizations penned a letter to the Washington Department of Health expressing their concern about the hold up on its rulemaking process for charity care — free or discounted hospital services provided to people who are financially eligible.
The Dec. 13 letter urges the state DOH to "hold hospitals accountable" and continue the rulemaking process to implement recent changes made by the legislature, arguing that the process will be further delayed due to a lawsuit filed by the Washington State Hospital Association regarding the state's enforcement guidance.
The groups, including nonprofit organization Dollar For, the Economic Opportunity Institute and Northwest Health Law Advocates, claim that Washington hospitals are not telling patients about charity care and that immigrants are disproportionately affected by hospitals failing to inform and denying patients charity care. They also allege that recent litigation filed by the WSHA appears to be a "delay tactic."
"It's obvious from looking at court records that people who can't afford a medical bill certainly can't afford the penalties and fees that get added as a result of getting sued," University of Washington researcher Kali Curtis said. "In many situations, people are working minimum wage jobs and having their wages garnished. This could all be avoided if hospitals were following the law and informing patients of charity care."
To address such healthcare disparities, the groups have asked the DOH to continue the rulemaking process and use recommendations submitted on July 26 to ensure hospitals:
- Screen all patients for charity care
- Comply with all notice requirements
- Consider patient conditions that may hinder their ability to apply for charity care
- Comply with all reporting requirements
- Provide necessary resources for patients with limited English proficiency so they can be informed of charity care
The WSHA said that it supports the DOH moving forward with the charity care rulemaking process and believes that updating the regulations will be key to providing hospitals more clarity on how to comply and for the public to understand what hospitals' obligations are.
"It is helpful to see where there may be opportunities for hospitals to improve their processes. If people are not getting information, then that is an area hospitals can dive into to make sure their staff are trained to provide the right information to patients in relation to charity care," a spokesperson for WSHA told Becker's. "Hospitals across the state are very supportive of patients getting access to care and access to charity care."
Separately, on Oct. 16, WSHA filed a suit against the state over the DOH's change in interpretation of a long-standing charity care law. According to the suit, hospitals statewide would be required to provide charity care for any service to any patient seeking it regardless of their ability to pay or an indigent person's residency.
Washington has had a charity care act in place since 1989 to provide residents in need with necessary care for free or at a low cost. Under its new revision, hospitals across the state were given until Jan. 16, 2024, to update their policies and comply with the rule.
WSHA argues that requiring hospitals to provide this care to anyone will reduce care access for Washingtonians and increase the costs of care for residents who will then subsidize the costs of free care to others from outside of the state.
"The result of the reinterpretation would be to expand Washington's already very generous charity care law to require that free or reduced care for services be mandated to apply to anyone in the world, a spokesperson for WSHA told Becker's. "That is the thing we're challenging. That question about the application and the change in the DOH interpretation has not come up in the rulemaking and is not associated with the rulemaking process."