Corporate Compliance

Q&A: Waiving collections of uninsured patients

Compliance Monitor, March 17, 2010

Q: Can my hospital waive collection of charges to an indigent, uninsured individual?

A: Yes. Nothing in CMS’ regulations, Provider Reimbursement Manual, or Program Instructions prohibit a hospital from waiving collection of charges to any patients, Medicare or non-Medicare, including low-income, uninsured or medically indigent individuals, if it is done as part of the hospital’s indigency policy. By “indigency policy” CMS means a policy developed and utilized by a hospital to determine patients’ financial ability to pay for services. By “medically indigent,” CMS means patients whose health insurance coverage, if any, does not provide full coverage for all of their medical expenses and that their medical expenses, in relationship to their income, would make them indigent if they were forced to pay full charges for their medical expenses.

In addition to CMS’ policy, the Office of Inspector General (OIG) advises that nothing in that agency’s rules or regulations under the federal anti-kickback statute prohibits hospitals from waiving collection of charges to uninsured patients of limited means, so long as the waiver is not linked in any manner to the generation of business payable by a federal health care program – a highly unlikely circumstance.

This Q&A is adapted from the FAQ section of CMS’ Web site. To view this and other FAQs click here.

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