These are the legal provisions related to hospital financial assistance/charity care in the state of Ohio. This is intended for educational use and should not be treated as legal advice.
Is there a state charity care law?
Yes, Ohio has its own law.
Qualifications for charity care in Ohio
Does the law specify a minimum Federal Poverty Level (FPL) for charity care?
Ohio's law regarding minimum FPL is as follows: To receive certain state benefits, a hospital must not charge patients at or below the poverty level who apply for assistance for basic, medically necessary hospital-level services.
Does the law specify a minimum deadline for applying for charity care?
Ohio's law regarding a minimum deadline is as follows: To receive certain state benefits, hospitals must accept an application for financial assistance for 3 years after sending the patient notice about the program with a bill. Nonprofits hospitals must accept an applicaiton for financial assistance for at least 240 days from when they sent the first post-discharge bill.
Does the law specify that having insurance disqualifies a patient for charity care?
Ohio 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 Ohio residents.
Does the law specify that patients must be US citizens or documented immigrants/lawful permanent residents to be eligible for charity care?
Ohio 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?
Ohio 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 Ohio
Does the law specify that patients cannot be responsible for a copay if they are eligible for charity care?
Ohio 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?
Ohio 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 Ohio
Does the law specify that hospitals cannot deny financial assistance to cover patient copays, coinsurance, or deductibles?
A nonprofit hospital must have and follow its Billing and Collections policy. At a minimum it cannot sell a debt, refer it to a credit reporting bureau, or engage in a judicial process (such as filing a lawsuit or garnishing wages) for at least 120 days after it sent the patient the first post-discharge bill.
Length of time charity care can be applied to future bills in Ohio
Does the law specify that hospitals must honor a charity care decision for future bills for a specific length of time?
Ohio law states that Inpatient hospital services must be determined separately for each admission unless the patient is readmitted within 45 days for the same underlying condition. For outpatient hospital services, a hospital may consider the eligibility determination to be effective for 90 days from the initial service date.