SummaryEnacted by the California State legislature, the Hospital Fair Pricing Act limits the amount all licensed, general acute-care hospitals (including nonprofit, for-profit, and public hospitals) can collect from low- and moderate-income uninsured and underinsured patients to the highest rate paid by a government program (typically Medicare). Under the law, hospitals must develop and disseminate written policies related to these discounted prices and free care, including eligibility requirements, decision-review processes, and debt-collection practices. They still send out initial bills based on full charges, leaving it to patients to apply for the discounted or free care. For those who apply, hospitals cannot initiate debt-collection activities for a period of time, and they must retroactively reimburse eligible patients who overpay based on the initial bill. The legislation has enhanced access to affordable medical care for low- and moderate-income patients who lack adequate insurance, with the vast majority of hospitals now offering discounted rates and/or free care to these individuals. Due in large part to the law, nearly 4 million individuals are now eligible for free care and another 1.3 million qualify for discounted prices. Overall, 60 percent of uninsured patients' emergency department visits qualified for free care and another 20 percent of their emergency department visits qualified for discounted rates.Suggestive: The evidence consists of a post-implementation evaluation of hospital pricing practices with respect to uninsured and underinsured patients, including the proportion offering discounts and free care to those in various income groups.
Developing OrganizationsHealth Access California
Use By Other OrganizationsMaryland, New Jersey, and New York have laws that require hospitals to notify patients of their financial assistance/free care policies; set financial thresholds for the provision of discounted or free care; and limit the amount charged to low-income uninsured and underinsured patients.
Date First Implemented2008
Patient PopulationVulnerable Populations > Impoverished; Medically uninsured; Insurance Status > Uninsured
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