Presumptive Eligibility
A growing trend in hospital and health system financial assistance programs is the incorporation of presumptive eligibility screenings for charity care. Presumptive eligibility refers to an automated process of analyzing readily available financial and other data to approximate a patient’s financial need. Implementing these presumptive eligibility screenings provides numerous benefits to both patients and the hospitals that serve them. Technological improvements and an increase in thirdparty solutions have made presumptive eligibility programs more accurate and easier to implement. This fact sheet provides hospitals and health systems with an overview of key considerations for implementing presumptive eligibility for charity care. The AHA encourages all members to consider whether some form of presumptive eligibility for charity care makes sense for their organization.
BackgroundCorewell Health, a 21-hospital nonprofit health system headquartered in Michigan, is strongly committed to communicating the availability of financial assistance to patients and the public, and to ensuring that consistent guidelines are applied to requests for financial assistance across…
Houston Methodist, an eight-hospital system headquartered in Houston, Texas, is leading the way by reenvisioning its financial assistance policies to meet the changing needs of its community. Houston Methodist maintains a standard financial assistance policy, which utilizes a traditional…
A growing trend in hospital and health system financial assistance programs is the incorporation of presumptive eligibility screenings for charity care. Presumptive eligibility refers to an automated process of analyzing readily available financial and other data to approximate a patient’s…
This fact sheet provides hospitals and health systems with an overview of key considerations for implementing presumptive eligibility for charity care. The AHA encourages all members to consider whether some form of presumptive eligibility for charity care makes sense for their organization.
Statementof theAmerican Hospital Associationfor theCommittee on Health, Education, Labor & Pensionsof theUnited States Senate“What Can Congress Do to End the Medical Debt Crisis in America?”July 11, 2024
In a study of 151 tax-exempt hospitals reported yesterday in JAMA Network Open, 84% updated their charity care policies between 2019 and 2021.
The American Hospital Association (AHA) appreciates the opportunity to provide comments in response to the Centers for Medicare & Medicaid (CMS) request for information (RFI) regarding access to coverage and care in the Medicaid and Children’s Health Insurance Program (CHIP) programs.
Since the first COVID-19 cases were diagnosed and the pandemic changed the ways in which patients were able to access traditional health care settings, providers were required to navigate significant challenges to ensure their services were still able to reach millions of patients. In response,…
CMS Issued New Guidance for States on the Medicaid Optional Uninsured COVID-19 Testing (XXIII) Group
The Centers for Medicare & Medicaid Services (CMS) released guidance on June 2 for states implementing the Medicaid Optional Uninsured COVID-19 Testing (XXIII) Group, established by the Families First Coronavirus Response Act.
CMS recently issued new Frequently Asked Questions to aid the Medicaid program and Children's Health Insurance Program in their response to the COVID-19 pandemic.