These are the legal provisions related to hospital financial assistance/charity care in the state of New York. This is intended for educational use and should not be treated as legal advice.
Is there a state charity care law?
Yes, New York has its own law.
Qualifications for charity care in New York
Does the law specify a minimum Federal Poverty Level (FPL) for charity care?
New York's law regarding minimum FPL is as follows: Under state law, for a hospital to receive certain state funds they are obligated to reduce the bill of a patient who is at or below 100% FPL to nominal amounts. Patients between 100% – 150% FPL may not be charged more than 20% of the hospital's highest volume payor, the Medicaid rate, or the Medicare rate, whichever is highest. Patients between 150% – 350% FPL cannot be charged more than 100% of the hospital's highest volume payor, the Medicaid rate, or the Medicare rate, whichever is highest.
Does the law specify a minimum deadline for applying for charity care?
New York law specifies the minimum at 240 days from the first post-discharge bill.
Does the law specify that having insurance disqualifies a patient for charity care?
New York 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?
Under state law, a hospital only has to give charity care to New York residents.
Does the law specify that patients must be US citizens or documented immigrants/lawful permanent residents to be eligible for charity care?
New York 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 of their immigration status.
Does the law specify that patients must owe a minimum bill amount in order to be eligible for charity care?
New York 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 patienr 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 New York
Does the law specify that patients cannot be responsible for a copay if they are eligible for charity care?
New York 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 refusing to apply charity care to any part of any bill for emergency or medically necessary care.
Does the law specify that hospitals cannot deny financial assistance to cover patient copays, coinsurance, or deductibles?
New York 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 refusing to apply charity care to any part of any bill for emergency or medically necessary care.
Collections laws related to charity care in New York
Does the law specify that hospitals cannot deny financial assistance to cover patient copays, coinsurance, or deductibles?
For a hospital to participate in New York's indigent care pool, a hospital cannot send a bill to collections if there is a pending financial assistance application. Otherwise, a bill can be sent to collections if the patient has been provided written notification of the financial assistance program within 30 days of the bill being referred to a collector.
Length of time charity care can be applied to future bills in New York
Does the law specify that hospitals must honor a charity care decision for future bills for a specific length of time?
New York 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.