Rochdale Village Health

Hospitals Must Provide Charity Care Assistance Program

February 14, 2012

Author: Trilby de Jung

Charity care refers to free or low cost care provided by hospitals to uninsured or underinsured patients. New York State has provided significant state funding to hospitals for charity care since 1983, but it wasn’t until 2007 that hospitals were actually required to provide charity care to uninsured patients under the Hospital Financial Assistance Law (HFAL). HFAL, codified at §2807-k(9-a) of the New York Public Health Law, provides advocates with a powerful new tool in advocating for uninsured clients facing hospital bills or in need of medical care from hospitals.

HFAL establishes a sliding fee scale rate for all uninsured patients living at or below 300% of the federal poverty line (FPL). All hospitals in New York must have financial assistance programs, with policies for determining eligibility for discounted care on file with the New York State Department of Health (NYSDOH). In addition HFAL limits collection practices for hospitals. For example, HFAL prohibits hospitals from issuing bills or collection notices while an application for financial assistance is pending.

Unfortunately, there is no parallel law applicable to health care providers who are not hospitals or directly employed by hospitals. Thus, patients who are billed by physicians practicing at hospitals but not employed by the hospital do not have the protection created by HFAL regarding limits on charges and collection practices, or the right to apply for financial assistance.

The article is part of New York Health Access website.  NY Health Access is a website created and maintained by Empire Justice, Self-Help, Inc., and the Legal Aid Society of New York City.  The site has proved extremely helpful to advocates across the state and is enjoying over 10,000 visits a day since its launch at the end of 2009.

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SKILLMAN, N.J. — The only hint that something is different inside millions of bottles of Johnson’s Baby Shampoo arriving on store shelves are two words: “Improved Formula.”

The shampoo has the same amber hue, the same sudsy lather and — perhaps most important — the same familiar smell that, for generations of Americans, still conjures memories of childhood bath time.

What’s different about the shampoo, and 100 other baby products sold by Johnson & Johnson, isn’t so much about what’s been added; it’s what’s missing. The products no longer contain two potentially harmful chemicals, formaldehyde and 1,4-dioxane, that have come under increasing scrutiny by consumers and environmental groups.

In response to consumer pressure two years ago, the company pledged to remove both chemicals from its baby products by the end of 2013, and this month, it said that it had met that goal. The reformulated products are making their way to store shelves around the world and will replace existing products over the next several months.

Revising a Formula for Baby Shampoo
Responding to pressure from consumers’ groups, Johnson & Johnson revised the ingredients in its baby shampoo to remove a formaldehyde-releasing preservative called quaternium-15.

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The first thing my new patient did when she walked into my office was breath an enormous sigh of relief. “It was so hard to get this appointment with you,” she said. “It took weeks!”

Unfortunately, my patient is not alone in her struggles. It is increasingly difficult for patients to find doctors and to get appointments with primary care physicians like myself, and it is likely to get worse, not better, as millions more gain health insurance under the Affordable Care Act.

The medical field has long been fretting about an upcoming doctor shortage. The aging of baby boomers already worried medical planners before changes to health care took a front seat, especially because so many doctors themselves are boomers and they will be aging (and retiring) at the same time. Add in the trend of medical students choosing sub-specialties over primary care, and now finding a doctor and getting an appointment can rival finding a parking space in midtown Manhattan.

Of course, much of the doctor shortage has to do with mismatched allocation of doctors — both with regard to geography and to specialty. In places like Boston or New York, you can’t walk down some blocks without tripping over a dozen dermatologists. And in many urban areas, multispecialty practices that take up entire floors of office buildings and freestanding M.R.I. facilities are nearly as common as Starbucks.

But for vast swathes of rural and small-town America and in poorer urban neighborhoods, many kinds of doctors can be hard to come by. Primary care is difficult to access, and specialty care requires complex, lengthy and expensive arrangements. Six states do not have their own medical schools — and the university hospitals and faculty practices that come with them. The worsening shortfall of doctors in years ahead will affect these communities disproportionately.

A recent special issue of Academic Medicine is devoted entirely to the challenge of matching the physician workforce to the needs of the patient population. The estimates of doctor shortages in the next 15 years range from 50,000 to more than 150,000. Whichever number turns out to be true, there will be legions of patients whose health will suffer.

What are some of the ways this crisis is being approached? The first is to increase the number of doctors. Since 2000, a dozen new allopathic medical schools have opened, along with more than a dozen osteopathic medical schools. These should supply a steady new crop of medical graduates.

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Todd Obolsky lives in a studio apartment in Manhattan, drives a leased Toyota Corolla and occasionally splurges on experimental cuisine in the East Village. When the Affordable Care Act allowed him to buy insurance for the first time in years, he was so price-sensitive that $30 a month made a difference in which plan he picked.

So the obvious choice was MetroPlus. It offered the best deal at the coverage level he was looking for — about $400 a month for a gold plan, the second-highest of the four levels. “That’s like as high as I can possibly go without living on rice,” he said.

He never noticed that it was the insurance company of New York City’s public hospital system; to a typical shopper on New York’s health exchange, it looks no different from big-name companies, like Empire or United.

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January 12, 2014

DALLAS — Amid the controlled chaos that defines an average afternoon in an urban emergency department, Dr. Marian Bednar, an emergency room physician at Texas Health Presbyterian Hospital Dallas, entered the exam room of an older woman who had fallen while walking her dog. Like any doctor, she asked questions, conducted an exam and gave a diagnosis — in this case, a fractured hand — while also doing something many physicians in today’s computerized world are no longer free to do: She gave the patient her full attention.

Standing a few feet away, tapping quickly and quietly at a laptop computer cradled in the crook of her left arm, was Amanda Nieto, 27, Dr. Bednar’s scribe and constant shadow. While Ms. Nieto updated the patient’s electronic chart, Dr. Bednar spoke to the woman, losing eye contact only to focus on the injured hand.

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Although the federal government is spending more than $22 billion to encourage hospitals and doctors to adopt electronic health records, it has failed to put safeguards in place to prevent the technology from being used for inflating costs and overbilling, according to a new report by a federal oversight agency.

The report, released on Wednesday by the Office of the Inspector General for the Health and Human Services Department, is the second in two months to warn about flaws in the oversight of the ambitious federal program aimed at converting patient records from paper to electronic. It comes as the Obama administration continues to face broad criticism over the troubled rollout of its health care law — especially the HealthCare.gov site.

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A husband and three children are left grieving after an otherwise healthy 29-year-old woman died of the flu virus.

Alice Jones, 29, died Jan. 6 at University General Hospital in Dallas after being sick for four days, ABC News reported.

“She was congested and had a sore throat and her head was hurting,” her husband, Darrell Jones, told ABC. “We both had a fever, but I got over it in the first two days.”

Alice had no history of asthma or respiratory illness, Darrell said. Neither he nor his wife had received a flu shot this year.

Alice became sick Thursday Jan. 2, and her symptoms worsened Sunday when she began experiencing shortness of breath. Darrell the next day took his wife to a clinic, where staff discovered her blood pressure was low. She was rushed to the hospital, where she began experiencing seizures — doctors were unable to stabilize her.

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