Corporate Compliance

Q&A: Uninsured patients

Compliance Monitor, July 7, 2010

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

A: Yes. Nothing in the 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.

Hospitals develop indigency policies to determine patients’ financial ability to pay for services. A medically indigent patients are those whose health insurance coverage, if any, does not provide full coverage for all of their medical expenses. If the hospital forced them to pay full charges for their medical expenses they would become impoverished.

There is nothing in OIG’s rules or regulations under the Federal anti-kickback statute that 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.

This Q&A is adapted from the CMS FAQ website page. To view this and other FAQs click here.

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