US Nonprofit Hospitals Have Widely Varying Criteria To Decide Who Qualifies For Free And Discounted Charity Care.

US nonprofit hospitals are required by law to have a charity care policy, but hospitals have significant discretion in determining specific eligibility criteria. Using a novel national database, this analysis revealed that nonprofit hospitals have chosen widely varying charity care eligibility guidelines. Among hospitals that offered free care, income limits ranged from 41 percent to 600 percent of the federal poverty guideline.

The Policy Alliance Between Hospitals and Debt Collection Agencies: Content Analysis of Public Comments on Regulations on Billing and Collections.

Significant debate persists about the obligations of nonprofit hospitals toward low-income patients. Many issues pertaining to this subject were discussed during the rulemaking process following the passage of the Affordable Care Act of 2010, which set forth rules for hospital billing and collection. In public comments, hospitals, debt collectors, and patient advocates debated what constituted "reasonable efforts" to determine whether a patient qualified for hospital financial assistance before resorting to extraordinary collection actions including lawsuits, wage garnishments, and adverse credit reporting.