NHeLP Comments on Proposed Regulations on Additional Requirements for Charitabl

Executive Summary

It is critical that low-income and underserved individuals have access to emergency and medically necessary care at charitable hospitals, particularly if some states do not expand Medicaid eligibility as required by the Affordable Care Act (ACA). These comments offer NHeLPÍs recommendations to improve the proposed regulations on charitable hospitals to ensure that no person is deterred from accessing needed hospital care because of cost.

September 24, 2012
 
Douglas Shulman, Commissioner Internal Revenue Service
Room 5203
P.O. Box 7604
Ben Franklin Station Washington, DC 20044
Attn: CC:PA:LPD:PR (REG-130266-11)
 
RE: CC:PA:LPD:PR (REG-130266-11)
Proposed Rule: Additional Requirements for Charitable Hospitals
 
Dear Commissioner Shulman:
 
The National Health Law Program (NHeLP) is a public interest law firm working to advance access to quality health care and protect the legal rights of low-income and underserved people. NHeLP provides technical support to direct legal services programs, community-based organizations, the private bar, providers and individuals who work to preserve a health care safety net for the millions of uninsured or underinsured low-income people.
 
It is critical that low-income and underserved individuals have access to emergency and medically necessary care at charitable hospitals, particularly if some states do not expand Medicaid eligibility as required by the Affordable Care Act (ACA). The requirements contained in ACA § 9007 are a much-needed step to ensure that no person is deterred from accessing needed hospital care because of cost. We appreciate the ability to provide comments on the proposed regulations implementing those statutory requirements. Our suggestions are based on our long experience advocating for the health rights of low-income and underserved people and aim to strengthen the proposed regulations to promote access to care and protect families from medical debt and bankruptcy.
 
We commend IRS for drafting a proposed rule that makes it possible for health care consumers to easily access basic information about hospital financial assistance programs for which they might be eligible, and for providing some assurance that charitable hospitals will not be permitted to engage in certain extraordinary collection activities unless and until it has been determined that a patient does not qualify for financial assistance. In general, we support the standards outlined in the proposed rule. However, we have several specific suggestions to make the rules more meaningful for low-income and underserved individuals, particularly those with Limited English Proficiency (LEP).
 
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