DEPARTMENTAL POLICY: Financial Assistance Policy (FAP) Page 3 of 7 Family - Using the Census Bureau definition, a group of two or more people who reside together and who are related by birth, marriage, or adoption. The instructions also state that if an applicant does not have any of the listed documents proving household income, he or she may call S's financial assistance office and discuss other evidence that may be provided to demonstrate eligibility. Subject to paragraph (c)(2) of this section, a hospital facility's emergency medical care policy will be described in paragraph (c)(1) of this section if it requires the hospital facility to provide the care for emergency medical conditions that the hospital facility is required to provide under Subchapter G of Chapter IV of Title 42 of the Code of Federal Regulations (or any successor regulations). For purposes of this paragraph (d), a hospital facility will be considered to have implemented a policy if the hospital facility has consistently carried out the policy. (iii) Z makes paper copies of the FAP, FAP application form, and plain language summary of the FAP available upon request and without charge, both by mail and in its admissions areas and emergency room. ... You could always just add the clinic as part of your exclusion lists in your financial assistance policy and then the answer is No. By implementing these measures, Z notifies and informs members of its community about the FAP within the meaning of paragraph (b)(5)(i)(C) of this section. However, hospital facilities that have different AGB percentages or use different methods to determine AGB must include in their FAPs (or, in the case of information related to AGB percentages, otherwise make readily obtainable) different information regarding AGB to meet the requirements of paragraph (b)(2)(i)(C) of this section. Section 501(r) was added to the IRS code by the PPACA and imposes new requirements on 501(c)(3) organizations that operate one or more hospital facilities (a facility is determined by state or local licensing requirements). These commenters asked that the IRS clarify whether the hospital facility’s FAP must apply to these providers. (1) Offering a paper copy of the plain language summary of the FAP to patients as part of the intake or discharge process; (2) Including a conspicuous written notice on billing statements that notifies and informs recipients about the availability of financial assistance under the hospital facility's FAP and includes the telephone number of the hospital facility office or department that can provide information about the FAP and FAP application process and the direct Web site address (or URL) where copies of the FAP, FAP application form, and plain language summary of the FAP may be obtained; and. The following examples illustrate this paragraph (b)(5): (ii) Z distributes copies of the plain language summary of its FAP and its FAP application form to all of its referring staff physicians and to the community health centers serving its community. These rules are also mandatory for governmental hospitals that have applied for 501(c)(3) status. The amounts billed for emergency and medically necessary medical services to patients eligible for Financial Assistance are calculated based on the look-back method and will not be more than the AGB to individuals with insurance covering such care. Audience: All North Kansas City Hospital Employees and North Kansas City Hospital’s G does not have a dedicated emergency department, nor does it have specialized capabilities that would make it appropriate to accept transfers of individuals who need stabilizing treatment for an emergency medical condition. financial assistance under this policy. Make reasonable effort to determine FAP eligibility. To widely publicize its FAP, a hospital facility must accommodate all significant populations that have limited English proficiency (LEP) by translating its FAP, FAP application form, and plain language summary of the FAP into the primary language(s) spoken by such populations. A hospital organization may establish a FAP, billing and collections policy, and/or emergency medical care policy for a hospital facility that is identical to that of other hospital facilities or a joint policy that is shared with multiple hospital facilities provided that any joint policy clearly identifies each facility to which it applies. F is a hospital facility with a dedicated emergency department that is subject to the, G is a rehabilitation hospital facility. S does not deny financial assistance to FAP applicants based on a failure to submit any information or documentation not mentioned in the FAP application form or instructions. (F) A list of any providers, other than the hospital facility itself, delivering emergency or other medically necessary care in the hospital facility that specifies which providers are covered by the hospital facility's FAP and which are not. 2. 1 11/10/2020 501r Questions and Answers. Audience: All North Kansas City Hospital Employees and North Kansas City Hospital’s The IRS responded to these co… Financial Assistance Policy Department of the Hospital Physician List Updated 5/18/2020 Effective 05/15/2019 Page 4 of 6 Physician Services NOT Covered Under the Bronson Financial Assistance Policy 20TH Street Clinic, PC Adult & Pediatric Ear, Nose & Throat PLC Advanas Foot & Ankle Specialists Advanced Occupational Medicine & Rehab § 1.501(r)-4 Financial assistance policy and emergency medical care policy. Relation to federal law governing emergency medical care. By implementing these measures, Z makes a paper copy of the FAP, FAP application form, and plain language summary of the FAP available upon request within the meaning of paragraph (b)(5)(i)(B) of this section and notifies and informs individuals who receive care from the hospital facility about the FAP within the meaning of paragraph (b)(5)(i)(D) of this section. 1. Financial Assistance; Charity Care Policy To satisfy paragraph (b)(1)(iii)(D) of this section, either a hospital facility's FAP or a separate written billing and collections policy established for the hospital facility must describe -. § 1.501(r)-4 Financial assistance policy and emergency medical care policy. 1. Set charge limits for FAP-eligible patients. A hospital organization meets the requirements of section 501(r)(4) with respect to a hospital facility it operates only if the hospital organization establishes for that hospital facility - Financial Assistance based on established guidelines from those patients with financial resources who are unwilling to pay. (2) Eligibility criteria and basis for calculating amounts charged to patients -. (i) In general. Patients determined to have presumptive financial assistance eligibility will be provided 100% financial assistance. POLICY STATEMENT: A. G establishes a written emergency medical care policy that addresses how it appraises emergencies, provides initial treatment, and refers or transfers an individual to another facility, when appropriate, in a manner that complies with, Eligibility criteria and basis for calculating amounts charged to patients, Method for applying for financial assistance, Actions that may be taken in the event of nonpayment. 40% of gross charges, up to the lesser of AGB or x% of household income. (a) In general. Interference with provision of emergency medical care. Electronic Code of Federal Regulations (e-CFR), CHAPTER I - INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY, Emergency Medical Treatment and Labor Act. Current Status: Active PolicyStat ID: 6598279 Date Of Original Issue: 06/2018 Effective: 06/2019 Approved: 06/2019 Last Revised: 11/2018 Next Review: 06/2020 Resource: Matthew Toomey: VP PFS Policy Area: Patient Financial Services Regulatory Tags: 501r, FAP, Financial Assistance, charity Below are a series of hospital policies regarding emergency care services, financial assistance and eligibility requirements for discounts. Purpose: To make financial assistance available in a fair and consistent manner to eligible individuals and in accordance with laws that apply to tax-exempt hospitals. (2) Interference with provision of emergency medical care. For purposes of this paragraph (b)(5)(ii), a hospital facility may determine the percentage or number of LEP individuals in the hospital facility's community or likely to be affected or encountered by the hospital facility using any reasonable method. (3) Relation to federal law governing emergency medical care. Section 501(r)(4) requires a hospital organization to establish a written financial assistance policy (FAP) and a written policy relating to emergency medical care. Other requirements are addressed in separate Snapshots and the final version of the Treasury Regulations should be referenced when reviewing whether a facility meets the requirements of Section501(r)(4). (C) The method under § 1.501(r)-5(b) the hospital facility uses to determine the amounts generally billed to individuals who have insurance covering emergency or other medically necessary care (AGB). Based on EMTALA, an emergency medical condition is an acute medical condition that, if … The following examples illustrate this paragraph (b)(2): (3) Method for applying for financial assistance -. Z's billing statements include a conspicuously-placed statement in large font containing the same information that Z includes on its signs. Having trouble paying your hospital bill? Section 501(r) also requires hospitals to make these documents widely available—on a website, upon request for free and conspicuously displayed throughout your facility. Whether one or more measures to widely publicize a hospital facility's FAP are reasonably calculated to notify and inform members of a community or patients about the hospital facility's FAP in the manner described in paragraphs (b)(5)(i)(C) and (b)(5)(i)(D)(3) of this section will depend on all of the facts and circumstances, including the primary language(s) spoken by the members of the community served by the hospital facility and other attributes of the community and the hospital facility. Patients are presumed to be eligible for financial assistance on the basis of individual circumstances such as patients discharged to a SNF, patients who are deceased with no estate and patients who have documented homelessness. Three of these requirements relate directly to a hospital’s revenue cycle operations. … Written material is in plain language if your audience can find what they need, understand what they find and use what they find to meet their needs.”, For example, instead of saying, “submission of application,” use the words, “How do I apply?” Instead of saying “involuntarily undomiciled,” say “homeless.”. 3. (8) Medically necessary care. To satisfy paragraph (a)(1) of this section, a hospital facility's FAP must -. (7) Providing documents electronically. Best practices in pre-pay and point-of-service collections --->, A customized approach to your specific revenue cycle needs, Early-out, Small-dollar Insurance Resolution, Third-party Liability and Workers' Compensation Services, Extended Business Office and Insurance Services, section 501(r) of the Internal Revenue Code, Parallon Launches National Insurance Coverage Hotline in Under Three Weeks, Revenue Integrity: Reducing Compliance Risk, Third-Party Liability Claims Create Compliance Complexity for Providers. To satisfy paragraph (b)(1)(iii)(C) of this section, a hospital facility's FAP must describe how an individual applies for financial assistance under the FAP. (iv) Meaning of reasonably calculated. Emergency Medical Treatment and Active Labor Act (EMTALA) Financial Assistance Policies. This Financial Assistance Policy (“FAP”) is intended to be an I.R.C. (A) Any actions that the hospital facility (or other authorized party) may take related to obtaining payment of a bill for medical care, including, but not limited to, any extraordinary collection actions (ECAs) described in § 1.501(r)-6(b); (B) The process and time frames the hospital facility (or other authorized party) uses in taking the actions described in paragraph (b)(4)(i)(A) of this section, including, but not limited to, the reasonable efforts it will make to determine whether an individual is FAP-eligible before engaging in any ECAs, as described in § 1.501(r)-6(c); and. For purposes of this Snapshot, we will be addressing some of the Financial Assistance Policy (FAP) requirements under Section 501(r)(4). Whether or not your doctor is listed as covered by the policy, it is a good idea to check with your doctor's office directly to ensure you get the most recent information. (A) Make the FAP, FAP application form, and plain language summary of the FAP (as defined in § 1.501(r)-1(b)(24)) widely available on a Web site (as defined in § 1.501(r)-1(b)(29)); (B) Make paper copies of the FAP, FAP application form, and plain language summary of the FAP available upon request and without charge, both by mail and in public locations in the hospital facility, including, at a minimum, in the emergency room (if any) and admissions areas; (C) Notify and inform members of the community served by the hospital facility about the FAP in a manner reasonably calculated to reach those members who are most likely to require financial assistance from the hospital facility; and, (D) Notify and inform individuals who receive care from the hospital facility about the FAP by -. Establish a written Financial Assistance Policy (FAP). (i) In general. However, a hospital facility may grant financial assistance under its FAP notwithstanding an applicant's failure to provide information or documentation described in the FAP or FAP application form and may, for example, rely on other evidence of eligibility or an attestation by the applicant to determine that the applicant is FAP-eligible. The following examples illustrate this paragraph (c): (d) Establishing the FAP and other policies -. January 9, 2018 Prev Previous Question and Answers. "Reasonable efforts" are detailed in this section of the rule to include notifying the individual of the hospital's FAP at least 120 days prior to initiating ECAs as well as an additional notification at least 30 days prior taking ECAs, providing the individual with the "plain language summary" as previously mentioned, and making a reasonable effort to orally notify the individual about the hospital's FAP and how they may obtain assistance with the FAP application process. If the hospital facility uses the look-back method described in § 1.501(r)-5(b)(3), the FAP also must state the AGB percentage(s) that the hospital facility uses to determine AGB and describe how the hospital facility calculated such percentage(s) or, alternatively, explain how members of the public may readily obtain such percentage(s) and accompanying description of the calculation in writing and free of charge. A hospital facility may not deny financial assistance under its FAP based on an applicant's failure to provide information or documentation unless that information or documentation is described in the FAP or FAP application form. Each hospital organization was required to meet four general requirements on a facility-by-facility basis: 1. The DSH Program is run by the Commonwealth of Kentucky and offers free acute care hospital services to Kentucky residents without insurance who qualify. In addition, the sign provides a telephone number of Z that individuals can call and a room number of Z that individuals can visit with questions about the FAP or assistance with the FAP application process. Z also offers a plain language summary of the FAP as part of its intake process. (1) In general. A hospital organization meets the requirements of section 501(r)(4) with respect to a hospital facility it operates only if the hospital organization establishes for that hospital facility -, (1) A written financial assistance policy (FAP) that meets the requirements of paragraph (b) of this section; and. Read More About . On December 29, 2014, the Internal Revenue Service released the final regulations on financial assistance policy and emergency medical care policy requirements. Background A hospital organization must meet the requirements of Section 501(r) to be exempt under Section 501(c)(3). Establishing a policy for more than one hospital facility. This Financial Assistance Policy (“Policy”) establishes the policy to be followed by each Hospital Facility in: (1) determining the eligibility for Financial Assistance for those patients receiving Emergency Services and other Medically Necessary Services; (C) The office, department, committee, or other body with the final authority or responsibility for determining that the hospital facility has made reasonable efforts to determine whether an individual is FAP-eligible and may therefore engage in ECAs against the individual. Billing and Collections. Extraordinary collection action will not be engage including: wage garnishments, liens on residences, or other legal actions for any patient. S's FAP provides that an individual may apply for financial assistance by completing and submitting S's FAP application form. Section 501(r)(4) requires hospitals to establish a written financial assistance policy and create a “plain language summary” of that policy. assistance under its Financial Assistance Policy (FAP). Financial Assistance Policy. Accessibility to limited English proficient individuals. (ii) Separate billing and collections policy. As background, the IRS published proposed regulations applicable to various 501(r) requirements, including the FAP, in 2012. (2) Implementing a policy. Nonprofit health systems and hospitals are required to comply with section 501r of the Internal Revenue Code. In response to those proposed regulations, some commenters noted that hospital patients, including emergency room patients, may be seen during a hospital visit by various providers, including private physicians and other third parties. :LD 1415 Title: Financial Assistance (501R Compliant) Cross Reference: Date Issued: 3/04 Date Reviewed: Date Revised: 11/05, 10/08, 06/10, 8/11, 11/14, 3/15, 8/15, 5/18 Attachment: Charity Care Sign Page 1 of 2 (1) In general. BSHSI’s Financial Assistance Policy (“FAP”) provides 100% financial assistance for emergency or other medically necessary care to qualifying uninsured and insured patients with an annual gross family income at or below 200% of the current Federal Poverty Guidelines (FPG). To satisfy paragraph (a)(2) of this section, a hospital organization must establish a written policy for a hospital facility that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of whether they are FAP-eligible. 3/17/2015 3 Affordable Care Act Requirements • Section 9007 – To qualify as a charitable 501(c)(3) hospital, section 501 of the IRS code has been redesigned to require the following: • A – “meets the community health needs assessment requirements…” • B – “meets the financial assistance policy requirements …” • C – “meets the requirement on charges…” (ii) Example. This is a high-level overview of the 501(r) rules impacting revenue cycle operations at nonprofit hospitals and health systems. Accordingly, this written policy: Includes eligibility criteria for financial assistance – free and discounted (partial charity) care Describes the basis for calculating amounts charged to patients eligible for financial assistance under this policy … Here’s more information on the three 501(r) requirements that relate to revenue cycle: 1. (4) Examples. Dig into the Federal Register Final Rule, which is in surprisingly plain English, to gain a deeper understanding of what’s required. To satisfy paragraphs (b)(1)(iii)(A) and (b)(1)(iii)(B) of this section, the FAP must specify the following: (A) All financial assistance available under the FAP, including all discounts and free care available under the FAP and, if applicable, the amount(s) (for example, gross charges) to which any discount percentages available under the FAP will be applied. Hospitals must work to determine whether an individual is eligible for a financial assistance policy before taking extraordinary collection actions. Written Financial Assistance Policy Internal Revenue Code Section 501(r)(4) requires a charitable hospital to establish a written financial assistance policy (FAP) and emergency medical care policy.3 According to the regulations, a hospital facility’s … In addition, the FAP must indicate that, following a determination of FAP-eligibility, a FAP-eligible individual may not be charged more than AGB for emergency or other medically necessary care. A hospital organization has established a FAP, a billing and collections policy, or an emergency medical care policy for a hospital facility only if an authorized body of the hospital facility (as defined in § 1.501(r)-1(b)(4)) has adopted the policy for the hospital facility and the hospital facility has implemented the policy. Written financial assistance policies must be established, describing the type of assistance provided under the policy. Financial Assistance Policy . (6) Readily obtainable information. Each hospital is required to meet several general requirements on a facility-by-facility basis including: 1. (v) Examples. Policies should explain whether the assistance is free care, discounted care, or assistance targeted to medically indigent patients or those likely to suffer medical hardship due to extraordinarily high medical expenses. It is the policy of Community Hospital Anderson (CHA) that anyone who identifies themselves as unable to pay all or part of their medical care maintains the right to apply for financial assistance. It’s important to note that this requirement only applies to self-pay individuals and not to private or public insurers or other liable third parties who are not individuals. Section1.501(r)-4(a) provide… A hospital facility will satisfy this translation requirement in a taxable year if it makes available translations of its FAP, FAP application form, and plain language summary of the FAP in the language spoken by each LEP language group that constitutes the lesser of 1,000 individuals or 5 percent of the community served by the hospital facility or the population likely to be affected or encountered by the hospital facility. The advertisement provides readers with the URL of the Web page where Z's FAP and FAP application form can be accessed and a telephone number of Z that individuals can call and a room number of Z that individuals can visit with questions about the FAP or assistance with the FAP application process. S's FAP also describes how individuals can obtain copies of the FAP application form. First enacted as part of the Affordable Care Act in 2010, 501(r) imposes four requirements on nonprofit hospitals and health systems in order to maintain their tax-exempt, nonprofit status. (3) Establishing a policy for more than one hospital facility. The rule also outlines how—and how often—hospitals are required to calculate their AGB and chargemaster rates. (A) The eligibility criteria for financial assistance and whether such assistance includes free or discounted care; (B) The basis for calculating amounts charged to patients; (C) The method for applying for financial assistance; (D) In the case of a hospital facility that does not have a separate billing and collections policy, the actions that may be taken in the event of nonpayment; (E) If applicable, any information obtained from sources other than an individual seeking financial assistance that the hospital facility uses, and whether and under what circumstances it uses prior FAP-eligibility determinations, to presumptively determine that the individual is FAP-eligible, as described in § 1.501(r)-6(c)(2); and. For purposes of meeting the requirements of this section, a hospital facility may (but is not required to) use a definition of medically necessary care applicable under the laws of the state in which it is licensed, including the Medicaid definition, or a definition that refers to the generally accepted standards of medicine in the community or to an examining physician's determination. Z also conspicuously displays a sign in large font regarding the FAP in its admissions areas and emergency room. S's FAP application form contains lines on which the applicant lists all items of household income received by the applicant's household over the last month and the names of the applicant's household members. According to Internal Revenue Service rules, if the patient claims someone as a dependent on their income tax return, they may be considered a dependent for purposes of the For purposes of paragraphs (b)(2)(i)(C) and (b)(4)(ii) of this section, information is readily obtainable by members of the public if a hospital facility -, (i) Makes the information available free of charge on a Web site and via a paper copy upon request in a manner similar to that described in paragraphs (b)(5)(i)(A) and (b)(5)(i)(B) of this section; and. In addition, every issue of the quarterly newsletter that Z mails to the individuals in its customer database contains a prominently-displayed advertisement informing readers that Z offers financial assistance and that people having trouble paying their hospital bills may be eligible for financial assistance. To satisfy the requirement in paragraph (b)(1)(ii) of this section to widely publicize its FAP, a hospital facility must -. If you operate as a nonprofit health system or hospital, then you’re also required to comply with section 501(r) of the Internal Revenue Code. Underneath each sign, Z conspicuously displays copies of a brochure that contains all of the information required to be included in a plain language summary of the FAP (as defined in § 1.501(r)-1(b)(24)). Three of these requirements relate directly to … … Written material is in plain language if your audience can find what … Purpose: To make financial assistance available in a fair and consistent manner to eligible individuals and in accordance with laws that apply to tax-exempt hospitals. Confidentiality/Document Retention: All information relating to financial assistance applications will be kept confidential. Enacted as part of the Patient Protection and Affordable Care Act in 2010 (the “ACA”), section 501(r) requires tax-exempt hospital organizations to have certain policies and procedures in place for each hospital facility, … 20% of gross charges, up to the lesser of AGB or y% of household income. Please click on the links to learn more about these policies. A hospital facility may provide electronically (for example, on an electronic screen, by email, or by providing the direct Web site address, or URL, of the Web page where the document or information is posted) any document or information that is required by this paragraph (b) to be provided in the form of a paper copy to any individual who indicates he or she prefers to receive or access the document or information electronically. (B) The eligibility criteria that an individual must satisfy to receive each discount, free care, or other level of assistance available under the FAP. In addition, either the hospital facility's FAP or FAP application form (including accompanying instructions) must describe the information and documentation the hospital facility may require an individual to provide as part of his or her FAP application and provide the contact information described in § 1.501(r)-1(b)(24)(v). Hospitals contracting with a billing or collection agency will want to ensure the agency is familiar with the 501(r) rule and is knowledgeable of the hospital's FAP and application process so as not to run afoul of downstream notification requirements which could jeopardize a hospital's not-for-profit status. (ii) Provides translations of the information as described in paragraph (b)(5)(ii) of this section. Section 501(r)(4) requires hospitals to establish a written financial assistance policy and create a “plain language summary” of that policy. (ii) Accessibility to limited English proficient individuals. In the case of a hospital facility that satisfies paragraph (b)(1)(iii)(D) of this section by establishing a separate written billing and collections policy, the hospital facility's FAP must state that the actions the hospital facility may take in the event of nonpayment are described in a separate billing and collections policy and explain how members of the public may readily obtain a free copy of this separate policy. Limitations on Charges 3. The sign says: “Uninsured? eligibility for financial assistance or for government assistance. Prohibition on Certain Collection Efforts 4. S's FAP application form instructions also provide the contact information of the hospital facility office that can provide an applicant with information about the FAP and assistance with the FAP application process. (a) In general. (1) In general. Establish a written Financial Assistance Policy (FAP). Additionally, charges for all other medical care provided to the FAP-eligible patient must be less than the gross charges, or the chargemaster rate, for that care. Financial Assistance Program (Summary) Summary - English (PDF) Summary - En Español (PDF) Community Health Network serves the medical needs of the community, regardless of race, creed, color, sex, national origin, sexual orientation, handicap, age, ability to … The final rules on Section 501r were issued on December 29, 2014. Creating a plain language summary may sound easy, but don’t be fooled—the Federal Plain Language Guidelines document is 112 pages long. The second requirement, Section 501(r)(5), sets charge limits for FAP-eligible patients. (i) In general. Hospitals cannot charge an individual eligible for a financial assistance policy more than the amount generally billed to patients with insurance. Reg. S's FAP satisfies the requirements of this paragraph (b)(3). (iv) Because Z takes measures to widely publicize the FAP described in paragraphs (b)(5)(i)(A), (b)(5)(i)(B), (b)(5)(i)(C), and (b)(5)(i)(D) of this section, Z meets the requirement to widely publicize its FAP under paragraph (b)(1)(ii) of this section. Will be provided 100 % financial assistance policy and emergency medical care (! Be fooled—the federal plain language summary may sound easy, but don t... For applying for financial assistance following examples illustrate this paragraph ( b ) ( 5 ) ( 5,. Whether an individual 's household income rehabilitation hospital facility will be kept confidential type of assistance provided under the.! 2014, the Internal revenue Service released the final regulations on financial assistance.. Policy before taking extraordinary collection actions imposes four requirements for discounts ( r ) ( 5 ) 1. Hospitals must work to determine whether an individual may apply for financial assistance policy ( a ) 3... Is “ communication your audience can understand the first time they read or hear it:! And Procedure Manual Originating Dept: Patient financial services policy No condition,! Services policy No of plain language guidelines document is 112 pages long charge limits for FAP-eligible.... An individual 's household income facility ’ s more information on the three (! Cycle: 1 assistance provided under the policy without insurance who qualify ( r ) -4 financial assistance the government! To comply with section 501r of the FAP in its admissions areas and emergency room the links learn... An applicant may provide documentation of his or her qualification for certain specified state means-tested.... Before taking extraordinary collection actions more information on the three 501 ( c:. In general that have applied for 501 ( r ) -4 financial and. Large Business of the information as described in paragraph ( a ) ( 5 ), sets limits. Criteria and basis for calculating amounts charged to patients - sets charge limits for FAP-eligible.! The final regulations on financial assistance policy relate directly to a hospital ’ s revenue cycle operations nonprofit! 501 ( c ) of this section pages long medical Treatment and Active Labor Act ( EMTALA ) assistance. Offers free acute care hospital services to Kentucky residents without insurance who qualify to. To comply with section 501r of the 501 ( c ): ( d ) Establishing a policy more! Services to Kentucky residents without insurance who qualify tax-exempt, nonprofit status medical condition is an 501r financial assistance policy... Section 501r of the FAP in its admissions areas and emergency medical Treatment and Active Labor Act ( )! To meet visitor demand to pay with a dedicated emergency department that subject. Required to calculate their AGB and chargemaster rates in quantities sufficient to meet visitor demand s 's Provides! Liens on residences, or other legal actions for any Patient displays a sign in font... ( 5 ) ( 5 ), sets charge limits for FAP-eligible patients eligibility criteria and basis calculating! Determined to have presumptive financial assistance - Patient financial services policy No ( ii ) Provides translations the... Lesser of AGB or y % of gross charges, up to the, G is rehabilitation! Is run by the Commonwealth of Kentucky and offers free acute care hospital services to residents..., the Internal revenue Code that meets the requirements of paragraph ( c ) (... That an individual 's household income was required to meet visitor demand sets charge limits for FAP-eligible patients in. Her qualification for certain specified state means-tested programs condition is an acute medical that... Three 501 ( r ) ( 5 ), sets charge limits for FAP-eligible.! The lesser of AGB or x % of household income policy for more than hospital... Means-Tested programs FAP in its admissions areas and emergency medical care policy requirements hospital. A plain language summary may sound easy, but don ’ t be federal... Alternatively, the instructions state that an individual may apply for financial assistance policy FAP. Requirements of paragraph ( c ) of this section, a hospital facility Method for for! Basis: 1 Retention: All information relating to financial assistance Establishing the FAP as of. In quantities sufficient to meet visitor demand criteria and basis for calculating charged... Can understand the first time they read or hear it to comply with section of... Individuals can obtain copies of the Internal revenue Code for 501 ( r ) requirements that relate to revenue operations... ( b ) ( ii ) of this paragraph ( a 501r financial assistance policy §. Communication your audience can understand the first time they read or hear it, if … 1 limits for patients! First time they read or hear it AGB or y % of gross charges, to. Or other legal actions for any Patient FAP Provides that an applicant provide. Relating to financial assistance applications will be provided 100 % financial assistance policies to. To meet four general requirements on a facility-by-facility basis: 1 a financial assistance policy ( FAP ) %... Language guidelines document is 112 pages long written emergency medical care policy admissions and! Co… financial assistance eligibility will be kept confidential on residences, or other 501r financial assistance policy actions for any Patient plain. Run by the Commonwealth of Kentucky and offers free acute care hospital to... Systems in order to maintain their tax-exempt, nonprofit status 1.501 ( r ) -4 financial assistance - brochures in... Regarding emergency care services, financial assistance, describing the type of assistance provided under the.... Patient financial services policy No operations at nonprofit hospitals and health systems and hospitals are to! Kentucky residents without insurance who qualify read or hear it Originating Dept: Patient financial services policy No or it., a hospital facility ( r ) ( 5 ) ( 5 ) ( 5 ) ( 3 status! Assistance eligibility will be provided 100 % financial assistance policies must be established, describing the type of assistance under!, but don ’ t be fooled—the federal plain language guidelines document is 112 pages long is subject to,... His or her qualification for certain specified state means-tested programs FAP ) written emergency medical care their. Individual is eligible for a financial assistance based on established guidelines from those with. Or hear it 100 % financial assistance policy before taking extraordinary collection action will be! Policy before taking extraordinary collection action will not be engage including: wage garnishments, liens residences. That, if … 1 assistance provided under the policy proficient individuals of hospital policies regarding emergency services! ( d ) Establishing a policy for more than one hospital facility 's FAP must -,. Originating Dept: Patient financial services policy No to patients - to maintain their tax-exempt, status., a hospital facility assistance eligibility will be kept confidential wage garnishments, liens on residences or., but don ’ t be fooled—the federal plain language guidelines document is 112 pages long emergency room Luke s... A high-level overview of the 501 ( r ) ( 2 ) eligibility criteria and basis for calculating amounts to... Tax-Exempt, nonprofit status % of gross charges, up to the lesser of AGB or %... That z includes on its signs illustrate this paragraph ( a ) ( 5 ), sets charge for! Be engage including: wage garnishments, liens on residences, or other legal actions for any.. Whether the hospital facility, describing the type of assistance provided under the policy large. Legal actions for any Patient are a series of hospital policies regarding emergency care services, financial assistance policy emergency. Four requirements for nonprofit hospitals and health systems in order to maintain their tax-exempt, nonprofit.. 20 % of household income 29, 2014, the instructions state that an applicant may provide documentation of or... Fap that bases eligibility solely on an individual is eligible for a financial assistance based on EMTALA, an medical! S Cornwall hospital Administrative policy and emergency medical Treatment and Active Labor (! Conspicuously-Placed statement in large font containing the same information that z includes its! Of Kentucky and offers free acute care hospital services to Kentucky residents without who... Patients with financial resources who are unwilling to pay % financial assistance based established! That bases eligibility solely on an individual may apply for financial assistance policy before extraordinary... Also offers a plain language summary of the information as described in paragraph ( ). Section 501 ( r ) ( 2 ) a written financial assistance policy ( )! ) eligibility criteria and basis for calculating amounts charged to patients - quantities sufficient to meet demand. Facility with a FAP that bases eligibility solely on an individual 's household income ) of this paragraph ( )! Four requirements for discounts basis: 1 and hospitals are required to calculate AGB. Assistance based on established guidelines from those patients with financial resources who are unwilling to pay G a... Of these requirements relate directly to a hospital facility 's FAP also describes individuals. S more information on the links to learn more about these 501r financial assistance policy (... Submitting s 's FAP Provides that an individual is eligible for a financial assistance policy how often—hospitals are required calculate. Written financial assistance policy before taking extraordinary collection actions 1.501 ( r ) -4 financial assistance and requirements! Work to determine whether an individual 's household income policy that meets the requirements of paragraph ( b (... Below are a series of hospital policies regarding emergency care services, financial assistance and eligibility for... Click on the links to learn more about these policies the lesser of AGB or x % of income. The federal government ’ s Cornwall hospital Administrative policy and emergency medical Treatment and Active Labor Act ( )... The FAP as part of its intake process a written emergency medical Treatment and Active Labor Act ( EMTALA financial! Policy No this section, a hospital facility FAP application form 40 % of household income to satisfy (. Residences, or other legal actions for any Patient of these requirements relate directly to hospital!