State opens Web site for hospital discounts

from The San Francisco Chronicle

Victoria Colliver, Chronicle Staff Writer

The state introduced a Web site Tuesday that helps consumers find out how much hospitals are willing to discount care for uninsured patients.

The site makes California the second state in the country, after New York, to give consumers a tool to shop and compare charity care or discount payment policies.

"This will allow them to determine whether they are getting a fair shake. Uninsured people are likely to be charged three to four times what an insurance company pays for exactly the same service," said Anthony Wright, executive director of Health Access California, a consumer advocacy group.

Hospitals have been criticized in recent years for being overly aggressive in trying to collect payments from patients, many of whom were uninsured.

Consumer complaints of hospitals engaging in such practices as garnisheeing wages or placing liens on properties led to numerous lawsuits around the country and a congressional inquiry into the billing practices of nonprofit hospitals. As part of settlements or policy changes, many hospitals amended their billing practices to offer uninsured patients more discounts and less onerous payment policies.

The site, called the Hospital Fair Pricing Program, is a result of a 2006 California law authored by former Democratic Assemblywoman Wilma Chan of Oakland.

The law prohibits the state's hospitals from charging low- to moderate-income patients more than the highest rates charged by Medicare or any other government payment program in which the hospital participates. Hospitals typically charge uninsured patients "sticker" prices, which are much higher than rates negotiated by insurers and government payers.

Using the site, consumers can search a hospital by name or location to find the hospital's discount pricing policy and download an application.

Policies differ, but patients who are uninsured or have inadequate coverage can qualify for low-priced or free care if they earn less than 350 percent of the federal poverty level, or if their medical costs exceed 10 percent of their annual family income. The site lists many hospitals that offer discounts to those earning up to 400 percent or 500 percent of the poverty level.

The Web site is still a work in progress, said Kenny Kwong, manager of acting and reporting systems for the Office of Statewide Health Planning and Development, which runs the site.

So far, policies for about 82 percent of California's 405 acute-care hospitals are posted, Kwong said. Some hospitals have submitted guidelines that have not yet been reviewed by the state agency, while about 50 hospitals have not submitted their policies.

While most of the hospitals that have yet to comply with the law are small or independent facilities concentrated in Southern California, they also include UC Irvine and UCLA medical centers.

The hospitals' trade group, the California Hospital Association, will work with centers to make sure they comply with the law, said spokeswoman Jan Emerson.

Emerson questioned whether consumers will use the site to shop for health services.

"If you're going to the ER, usually you're going there in an emergency situation - not to a governmental Web site," she said.
Comparing care

California law requires every hospital to have a charity care and discount payment policy. A new Web site helps consumers compare policies, determine what income levels qualify for discounted and free care and get application forms. For more information, visit links.sfgate.com/ZCFK.

Source: Office of Statewide Health Planning and Development