Corporate Compliance

Tip: Discounting uninsured or underinsured patients

Compliance Monitor, October 20, 2010

Hospitals may discount services to uninsured and underinsured patients who are unable to pay their hospital bills. When providing discounts, the OIG states that hospitals:

  • Should reflect full uniform charges on the Medicare cost report and inform the fiscal intermediary that it has reported its full charges
  • Can forgo collection efforts aimed at a Medicare patient if the hospital documents that the patient is indigent or medically indigent
  • May claim discounted amounts as Medicare bad debt after determining that only the patient is legally responsible for the unpaid deductibles and coinsurance
  • Can determine their own indigent-care criteria if they uniformly apply it to Medicare and non-Medicare patients

This week’s tip was adapted from The Compliance Program Effectiveness Handbook. For more information about the book or to order your copy, visit the HCMarketplace.

Most Popular