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APHA Scientific Session and Event Listing

Recorded presentation

David M. Ackman, MD, MPH and Linda Cucci. Nassau County Department of Health, 240 Old Country Road, Mineola, NY 11501, 516 571 2260, dma02@yahoo.com

Background: Not-for-profit hospitals provide community benefits in return for their tax-exempt status, including substantial amounts of uncompensated medical care. Critics claim that hospitals are not held accountable for these obligations, either by the IRS or by state regulators. There is also concern over aggressive hospital billing practices aimed at poor and indigent patients. Methods: In 2003, the Nassau County Legislature enacted a “Charitable Medical Care” Law that requires hospitals operating in the county to establish and publicize policies for patients to apply for charity care. Hospitals are required to report to the county health department the number of patients applying for and being granted charity care, the total episodes of care provided, where these patients live, and total dollar amount of uncompensated care provided. Results: All twelve hospitals established policies and posted notices making patients aware of charity care policies. Hospitals reported providing between $300,000 and $22 million of charity care. Reports of patients granted charity care, and the amount provided varied widely, and was largely due to differences in interpretation of reporting requirements and the local law. Conclusions: Hospitals, faced with financial pressures from all quarters, are also considered a local resource, with responsibilities for serving the poor and uninsured. Laws of this type may bring attention to the issue and prompt progressive policies but was not demonstrated to more equitably distribute the burden of uncompensated care or otherwise change hospital practices.

Learning Objectives:

• Local innovations in providing health care for the uninsured.
• Local regulation of hospitals, particularly in regard to provision of community benefits.

Keywords: Hospitals, Health Care Politics

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation