Hospital alters bill system

Beginning late last week, the Yale-New Haven Hospital has instituted changes to its billing policy in order to further aid uninsured and under-insured patients.

The hospital has established a “sliding scale discount program” that will provide care at reduced prices for patients with incomes from 250 percent of the Federal poverty level up to 350 percent of the poverty level.

To receive discounted care, patients can apply to the program at the hospital. Patients will be only responsible for the hospital’s cost of providing care, which results in approximately a 50 percent discount, hospital spokesman Vincent Petrini said.

Patients at or below 250 percent of the poverty level qualify for free medical care by applying first through Medicare, as has always been the policy at the hospital.

The program, proposed last year, was finally made possible by a recent clarification by the federal government on its legality.

“Back in December, the American Hospital Association (AHA) inquired about the ability of hospitals to implement a sliding scale program — to discount patients, without discrimination to other patients that are covered with insurance,” Petrini said. “The federal government came out about a month ago … and indicated that the sliding scale programs were appropriate.”

Petrini said the changes demonstrate the hospital’s continued efforts to help uninsured and under-insured patients pay for care.

“[The program] is consistent with the hospital’s commitment to the community,” Petrini said. “It’s a policy we announced last summer that we would begin to explore, and true to that commitment, we’ve moved forward.”

Service Employees International Union District 1199 has openly criticized the hospital’s debt collection procedures, and has helped poor patients bring legal actions against the hospital.

District 1199 spokesman Bill Meyerson said the recent changes are consistent with previous demands made by the union.

“The sliding scale program … is a demand we have made a year ago, so we take some responsibility for these changes,” Meyerson said.

District 1199, which represents approximately 140 dietary workers at the hospital, has been involved in various lawsuits against the hospital on union issues.

While Meyerson said the changes are a step in the right direction, he questioned the effectiveness of the new changes.

“[Free care for patients] at or below 250 percent of the poverty level … has been the stated policy of the hospital in the past, but people … haven’t been informed of the funds, and the application process is so Byzantine that people are discouraged,” Meyerson said. “This does not address whether access to care has improved.”

In addition, Meyerson questioned the program’s effect on patients who were made to pay, even though they would not have under the new program.

“Is the sliding scale policy retroactive?” Meyerson said. “How does it affect people who should have benefited from something like this before?”

Petrini said the program will apply to all applications that are currently under evaluation.

“The program is effective immediately, and we will certainly review any applications that are currently in the evaluation process to assess their eligibility for access to these funds,” Petrini said.

The difficulties of funding health care is not unique to Yale-New Haven Hospital. In December, the AHA, which advocates on behalf of 5,000 American hospitals, said it would provide guidelines to hospitals on making care more affordable for uninsured and under-insured patients, and how to offer more innovative payment programs.

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