These are the legal provisions related to hospital financial assistance/charity care in the state of Pennsylvania. This is intended for educational use and should not be treated as legal advice.
Is there a state charity care law?
Pennsylvania's law is as follows: Pennslyvania has a very limited state charity law that mandates hospitals have a financial assistance policy without specifying what the policy must contain.
Qualifications for charity care in Pennsylvania
Does the law specify a minimum Federal Poverty Level (FPL) for charity care?
No, Pennsylvania law does not specify a minimum FPL, so federal law would apply.
Federal law does not set a minimum FPL. Nonprofit hospitals are simply required to follow their financial assistance policy.
Does the law specify a minimum deadline for applying for charity care?
Pennsylvania 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?
Pennsylvania 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?
Pennsylvania 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 residency.
Does the law specify that patients must be US citizens or documented immigrants/lawful permanent residents to be eligible for charity care?
Pennsylvania 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?
Pennsylvania 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 Pennsylvania
Does the law specify that patients cannot be responsible for a copay if they are eligible for charity care?
Pensslyvania prohibits requiring a copay for emergency services.
Does the law specify that hospitals cannot deny financial assistance to cover patient copays, coinsurance, or deductibles?
Pensslyvania prohibits requiring a copay for emergency services.
Collections laws related to charity care in Pennsylvania
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 Pennsylvania
Does the law specify that hospitals must honor a charity care decision for future bills for a specific length of time?
Pennsylvania 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.