The American Hospital Association and the Catholic Health Association replied to inquiries by Sen. Chuck Grassley (R-Iowa) into hospitals' handling of uninsured and low-income patients. In a letter to Grassley, chairman of the Senate Finance Committee, outgoing AHA President Richard Davidson called for legislation to exempt hospitals from class-action lawsuits over uninsured care if the hospitals' charity-care policies meet or exceed criteria that was approved by the AHA board April 29. According to the criteria, hospitals must publicize financial-aid policies and provide free care to uninsured patients earning less than 100% of the federal poverty level. For patients earning from 100% to 200% of the poverty level, hospitals should bill no more than 125% of the Medicare rate or the price paid by public or private insurers. Davidson said hospital charity care "should in no way substitute for state efforts to provide or expand coverage to the uninsured."
The AHA board also approved new guidelines for tallying and reporting "community benefit spending," an umbrella term used to describe various activities from free and discounted care to public health education. The association called for hospitals to undertake a periodic community-needs assessment; assign an employee to oversee community benefit plans; use benefit guidelines jointly drafted by the CHA and VHA; and include the total with yearly Internal Revenue Service filings. The CHA, meanwhile, answered several of Grassley's questions about the organization and how it advises members to account for community benefits. In an interview with Modern Healthcare, Sister Carol Keehan, the CHA's president and chief executive officer, said the organization's charity-care guidelines are under revision. We're trying to make sure we're labeling and measuring everything in the same way and doing it in a transparent way," Keehan said. -- by Melanie Evans