AHA Issues Guidelines Regarding Billing and Collection Practices

June 1, 2012 Author: Mark Faccenda

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On May 5, 2012, the American Hospital Association ("AHA") issued a Statement of Principles and Guidelines reflecting its position on hospital billing and collection practices under the Patient Protection and Affordable Care Act ("PPACA").  The AHA guidelines broadly address how hospitals should help patients with payment for hospital care, how hospitals may make care more affordable for those qualifying for financial assistance and how hospitals may ensure fair billing and collection practices. AHA suggests that "hospitals should provide financial counseling to patients about their hospital bills and should make the availability of such counseling widely known." AHA also suggests that hospitals should "widely publicize" their financial assistance policies including "eligibility criteria, the basis for calculating charges and the method for applying for financial assistance."

Following PPACA requirements, the AHA suggests that hospitals "should have policies to limit charges for emergency and other medically necessary care for those who qualify for financial assistance to no more than the amounts generally billed to individuals who have insurance." In light of growing concern over aggressive collection practices, AHA has recommended that "hospitals should ensure that patient accounts are pursued fairly and consistently, reflecting the public's high expectations of hospitals." Hospital policies should "[ensure] that reasonable efforts are made to determine whether an individual is eligible for financial assistance before undertaking significant collections actions" and should "define the standards and scope of practices to be used by outside collection agencies acting on their behalf."

More information on AHA's guidelines may be found here.  Mark Faccenda

Fulbright & Jaworski L.L.P. Washington's Health Care Group

Cori Annapolen Goldberg
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Peter Leininger
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Tom Dowdell
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Lesley Reynolds    
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Mark Faccenda
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Rick Robinson
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Megan Fanale Engel*
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Joel Slomoff
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Glenn Jones
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Selina Spinos
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*Ms. Engel is admitted to practice only in Virginia.  Practice
supervised by principals of the firm admitted in the District of Columbia