These are the legal provisions related to hospital financial assistance/charity care in the state of Georgia. This is intended for educational use and should not be treated as legal advice.
Is there a state charity care law?
Yes, Georgia has its own law.
Qualifications for charity care in Georgia
Does the law specify a minimum Federal Poverty Level (FPL) for charity care?
Georgia's law regarding minimum FPL is as follows: Hospitals receiving money from the indigent care trust fund must forgive all debt for patients below 125% FPL and must provide services on a sliding scale for patients between 125 – 200% FPL.
Does the law specify a minimum deadline for applying for charity care?
Georgia's law regarding a minimum deadline is as follows: 240 days from when they sent the first post-discharge bill for charity care from a non-profit hospital per federal law. For hospitals participating in the indigent care trust fund which distributes medicaid funding through the state, there is no deadline to try and access state funds.
Does the law specify that having insurance disqualifies a patient for charity care?
Georgia law does not address this matter, so federal law would apply.
Federal law does not directly answer this. However, we think that federal law prohibits nonprofit hospitals from denying patients charity care because they are insured.
Does the law specify that patients must be residents to be eligible for charity care?
The state indigent care trust fund is only available for for a US citizen who is a resident of State of GA.
Does the law specify that patients must be US citizens or documented immigrants/lawful permanent residents to be eligible for charity care?
The state indigent care trust fund is only available for for a US citizen who is a resident of State of GA.
Does the law specify that patients must owe a minimum bill amount in order to be eligible for charity care?
Georgia law does not address this matter, so federal law would apply.
Federal law says that non-profit hospitals may not require a minimum bill amount for a patient to qualify for charity care. All emergency and medically necessary care conducted at a non-profit hospital is eligible for charity care.
How the law applies to copays in Georgia
Does the law specify that patients cannot be responsible for a copay if they are eligible for charity care?
Georgia state law allows hospitals to charge a co-pay. However, after you are granted financial assistance by a non-profit hospital you are entitled to a refund of any amount you have over-paid per 26 CFR 501(c)(6)(i)(C)(2).
Does the law specify that hospitals cannot deny financial assistance to cover patient copays, coinsurance, or deductibles?
Georgia state law allows hospitals to charge a co-pay. However, after you are granted financial assistance by a non-profit hospital you are entitled to a refund of any amount you have over-paid per 26 CFR 501(c)(6)(i)(C)(2).
Collections laws related to charity care in Georgia
Does the law specify that hospitals cannot deny financial assistance to cover patient copays, coinsurance, or deductibles?
A nonprofit hospital may send you to collections at any time, but they must wait 120 days from when they sent the first post-discharge bill to sell your debt, report it to a credit reporting bureau, or engage in a judicial process such as a lawsuit or garnishment.
Length of time charity care can be applied to future bills in Georgia
Does the law specify that hospitals must honor a charity care decision for future bills for a specific length of time?
Georgia law does not address this matter, so federal law would apply.
Federal law does not directly address this. Nonprofit hospitals are simply required to follow their financial assistance policy.
Special Notes: The state requires hospitals serving disproportionately low-income patients to conduct an indigency screening of every patient who claims they cannot pay.