The bipartisan Healthcare Consumer Protection Bill was submitted to the State Capitol in the bequest of State Treasury Secretary Dale Folwell.
House Bill 1039, submitted on Tuesday, is entitled “Medical Debt De-Weaponization Act”. The main sponsors are Hartford Democrat Howard Hunter and Cumberland’s Billy Richardson, and Chowan’s Republican Ed Goodwin and Currituck’s Bobby Henig.
The bill must clear house banking, health, rules, and operational committees before reaching the Chamber of Commerce floor for voting.
There is also an interesting combination of 39 conservative and progressive co-sponsors, including Congressman Ply Harrison, Congressman D-Gilford, Congressman Lee Zachary and Congressman Jeff Zenger, both including R-Forsyth.
“I’ve been very annoyed by all the stories I’ve read and heard about the overwhelming burden of medical debt,” Harrison said. “It is responsible for two-thirds of bankruptcies, including my members.”
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“Of course, passing the Medicaid expansion would help, but the proposal seems to provide some protection from violent pricing,” Harrison said.
Intention of billing
According to the bill and Folwell’s statement, the bill’s mission is to “set parameters for the provision of philanthropic care and limit the ability of large healthcare facilities to claim unreasonable interest, relatives, poverty alleviation, and consumer protection laws. Is to create an unfair tactic for debt collection. “
Folwell’s primary concern in requesting HB1039 is the state’s health planning oversight body, with more than 727,000 participants, including current and retired state employees, teachers, and legislators. The largest purchaser of medical and pharmaceutical services in North Carolina.
“Inflation is at its highest level in 40 years, and North Carolina is suffering from great anxiety, so families need to be protected from the weaponization of medical debt. One way to do this is with large-scale medical care. The provider’s financial support, and its appropriate level of charity care, is available to working families in need.
“Lifesaving measures should not sacrifice your life savings.”
“We haven’t digested and analyzed the bill yet, and we don’t have that position,” the North Carolina Hospital Association said on Friday.
“The first high-level view is that federal law already addresses some of the requirements of the bill, and the North Carolina State Capitol addresses many of the state-specific issues associated with fair claim and collection practices. Was already passed in 2013. “
NCHA said hospital charity spending and community interest investment activities are “transparent and responsible.”
“North Carolina nonprofit hospitals submit audits to state and federal tax regulators each year. Regulators determine that hospitals are fulfilling their tax status obligations.
“Compliance violations can lead to the revocation of hospital tax exemption status, which never happened in North Carolina.”
Legislative response
HB1039 represents the legislative response to the Johns Hopkins Bloomberg School of Public Health’s October analysis of nonprofit and nonprofit hospitals in North Carolina. The analysis was requested by Folwell and SHP, whose accounting has supervisory authority.
Analysis revealed that many of these hospitals, including the three largest in the triad, do not fully respect philanthropy. A video link to the presentation can be found at https://www.youtube.com/watch?v=pL1j4-n3ea8.
North Carolina’s largest non-profit hospital system achieved an estimated $ 1.8 billion or more tax credits between 2019 and 2020, according to the report. For most of these systems, charity spending did not exceed 60% of tax cuts, according to researchers.
For the major healthcare systems servicing the triad, the Johns Hopkins Report lists annual forecasts of tax exemptions compared to the system’s disclosed charity care funds.
• Atrium Health was reported to be exempt from state tax worth $ 44.1 million and provide $ 260.1 million in charity care.
• Novant Health was reported to be exempt from state tax worth $ 324.1 million and provide $ 179.1 million in charity care.
• ConeHealth was reported to be exempt from state tax worth $ 131.6 million and provide $ 105.7 million in charity care.
• Atrium’s affiliate, Wake Forest Baptist Medical Center, was reported to be exempt from state tax worth $ 210.3 million and provide $ 54.8 million in charity care.
Medical Debt Law
The bill is similar to the consumer protection laws of other states that seek to protect families from the effects of medical debt on Americans.
In 2019, some nonprofit hospitals in North Carolina will have their own policies, according to another study conducted by the Baker Institute for Public Policy, the National Academy of Health Policy, and SHP at Rice University.
In addition, up to 28.7% of hospital bad debts were charged to poor patients who are likely to be eligible for charity care.
HB1039 requires healthcare facilities to develop a healthcare debt mitigation policy based on the existing framework of financial support plans under the Federal Health Insurance System Reform Act.
Folwell said the pursuit of consumer health care protection was facilitated by the lack of progress in tackling the medical debt problem over the last 40 years.
“We have chosen to co-sponsor the bill because it may limit predatory lending and collection practices for some healthcare providers / lenders,” Zachary said.
“According to some people working in Treasury Secretary Folwell’s office, consumer debt, whether it’s necessities or consumer debt, is all under the same law.
“This bill will create a new law on medical / veterinary debt for the necessary procedures,” Zachary said. “It’s something that both Democrats and Republicans can vote for.”
Attorney General Review
In January, the Atrium Wake Forest Baptist, Korn, and Novant were determined to be fully compliant with federal regulations to improve patient price transparency, according to the North Carolina Attorney General’s Office. ..
However, at the time of the report, the office stated that it was not fully compliant with the Triad in 14 counties and eight regional or specialized hospitals in northwestern South Carolina.
The Federal Center for Medicare and Medicaid Services rolled out the implementation of the Hospital Price Transparency Initiative on January 1.
All hospitals “must provide clear and accessible pricing information online for the items and services they offer,” CMS said. Hospitals may face civil penalties in case of violation.
According to a review by the Attorney General, 122 hospitals across the state are fully compliant with CMS regulations.
On the other hand, 16 hospitals do not comply with the requirement to provide a machine-readable service and price list. The hospitals listed in that category are Elkin’s Allegany, Ash, Hugh Chatam, Mount Airy’s Northern, and Ashboro’s Randolph.
One hospital — Holly Hill — does not comply with the requirement to provide a consumer-friendly shoppable list.
Eight hospitals are not compliant with either Kindred in Greensboro, LifeBright in Stokes County, or Select Specialty in Greensboro.
Some hospitals in the non-compliant category have informed the Attorney General’s office that they are updating their tools to comply with the regulations.
In June, Attorney General Josh Stein encouraged hospitals in North Carolina to “encourage compliance to better provide the information patients need to make informed and selective choices about health care. I will do it. “
“By making prices transparent, hospitals allow patients to shop and keep medical costs down,” says Stein.
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