Hospital Association Kills Greenlick’s Attempt to Clarify Charity Care for Patients

The spokesman for the Oregon Association of Hospitals and Health Systems said member hospitals are already giving notice to patients about financial assistance in paying medical bills, but Rep. Mitch Greenlick wanted uniform standards across the state hospital system.

The Oregon Association of Hospitals and Health Systems has derailed a legislative attempt to make its members streamline their charity care services and provide a common form describing how to qualify for financial assistance for medical care across all hospitals.

Rep. Mitch Greenlick, D-Portland, told The Lund Report that he spiked House Bill 4084 on Monday after hospital association lobbyist Sean Kolmer went back on an agreement that had allowed the hospital association itself to rewrite the bill.

“The hospital association asked us for that amendment and after we rewrote it they objected to their own amendment,” Greenlick said. “I was very frustrated.”

He sponsored HB 4084 with nine other Democrats but said he had agreed at the outset to strive for a consensus and avoid passing a controversial bill in the short legislative session. That promise gave the hospital association the chance to kill his reforms.

The association’s amendment would have changed “charity care” to “financial assistance” and delayed until 2019 requirements that hospitals post visible displays of their assistance policies and provide paperwork to each patient about potential assistance with bills. A common form from the hospital association that all member hospitals would use was delayed until 2020.

Hospital association spokesman Philip Schmidt said that hospitals were already notifying patients of their assistance policies, with all hospitals offering to write off bills for people with incomes below 200 percent of poverty, which is $50,000 for a family of four. He added that some hospitals help people above that figure.

Felisa Hagins, the political director at SEIU Local 49, doubted the hospital association’s sincerity: “They would much rather have you jump through the hoops,” said Hagins, who also negotiated on HB 4084. Hagins wanted a stronger bill but was ready to accept the compromise. “That bill calls into question their status as ‘charitable organizations’ if they won’t even agree to a common form.’”

Oregon’s nonprofit hospitals are required to write off the cost of care for people who cannot afford to pay, rather than to turn them over to debt collectors, and to make other charitable contributions in order to avoid paying taxes both to Oregon and the IRS.

The amount of charitable care each hospital must offer and who qualifies is not always clear, however, and use of charity care has dropped dramatically since the Affordable Care Act expanded Medicaid to about 350,000 Oregonians.

Last year, the hospitals, Greenlick and SEIU, could not reach an agreement on setting statutory standards for charity care levels in Oregon. This year, Greenlick did not reopen that conversation, and instead attempted to just provide a simpler process for consumers, but was again thwarted.

In an email, Schmidt denied that his organization is trying to stymie Greenlick’s efforts to help consumers and promised to help with legislation in 2019.

“[The] Hospitals’ intent is the same as Chair Greenlick’s: an easy, quick and seamless way to access financial assistance at hospitals across Oregon,” Schmidt explained. “But the further we discussed the implementation details of this policy, the more it was clear this was a conversation for the interim. We strive to get this right for our patients and their families, and not move something quickly with unintended consequences.  

“Hospitals are committed to working to tackle this issue through the interim with stakeholders, including Chair Greenlick. In the meantime, hospitals continue to provide notification of charity care policies to their patients, along with the resulting free or reduced price services to those who are in need. As announced in 2015, Oregon hospitals have policies ensuring free care to those earning below 200 percent of the federal poverty level, and many have higher thresholds. We aim to build on those policies with any work in this area and make this area as smooth and seamless as possible for patients in need of financial assistance.”

Reach Chris Gray at [email protected].

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