HMNH will provide without discrimination, care for emergency medical conditions (EMTALA) to individuals regardless of their eligibility under the Financial Assistance Program (FAP). HMNH will not engage in activities demanding emergency department patients pay before receiving treatment for emergency medical conditions or permit debt collection activities in respective departments where EMTALA applies. It is the policy of Henry Mayo Newhall Hospital (HMNH) to comply with the State/Federal regulations including but not limited to Assembly Bill 774 and IRS 501(r) related to the discounting of patient bills as reflected in the policy titled: The Financial Assistance Program. This program covers medically necessary services. Medicare defines medically necessary care as “health-care services or supplies needed to prevent, diagnose, or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine.” Nonprofit credit counseling services may be available in your area or the City of Santa Clarita.
Types of Financial Assistance:
- Financial Assistance Program (FAP) Care
- Eligibility determination may be made through a paper application.
- Eligibility determination may be made through an oral interview; approval may be granted without formal supporting documentation and may include general FAP.
- All open patient accounts will be reviewed for consideration.
A. State Regulation requires hospitals to provide a FAP (free care).
All services of HMNH will be available for free care, if eligible. Patients whose family income is at or below 200% of the Federal Poverty Level (FPL) may be eligible. These levels are updated as published through the Tobacco Tax Trauma Program and adjusted upon receipt.
B. State Regulation requires hospitals to provide a FAP Discount Payment Process.
- All services of HMNH will be available for discount payment process, if eligible.
- Uninsured or underinsured patients whose family income is between 200.1% through 400.0% of the (FPL) may be eligible. Self pay patient means a patient who does not have coverage from a health insurer, health care service plan, Medicare or Medi-Cal, and whose injury is not a compensable injury for purposes of workers’ compensation, automobile insurance, or other insurance as determined and documented by the hospital may be eligible for discounted payments for all medically eligible services.
- Patients with high medical costs (a person whose family income is between 200.1% through 400.0% of the FPL) who has insurance coverage and whose out-of-pocket medical expenses in the prior twelve (12) months exceeds 10% of the patient’s family income may be eligible for discounted payments for all medically eligible services.
- Reasonable payment plan means monthly payments that are not more than 10 percent of a patient's family income for a month, excluding deductions for essential living expenses. Essential living expenses means, expenses for any of the following: The hospital and the patient will negotiate the terms of the payment plan, and take into consideration the patient’s family income and essential living expenses. If the hospital and the patient cannot agree on the payment plan, the hospital will accept a:
"Reasonable payment plan" with monthly payments that are not more than 10 percent of a patient's family income for a month, excluding deductions for essential living expenses. "Essential living expenses" means, for purposes of this subdivision, expenses for any of the following: rent or house payment and maintenance, food and household supplies, utilities and telephone, clothing, medical and dental payments, insurance, school or child care, child or spousal support, transportation and auto expenses, including insurance, gas, and repairs, installment payments, laundry and cleaning, and other extraordinary expenses.” The hospital will agree to an extended payment plan that allows payment of the discounted price over time along with an option for the patient and their family to negotiate the terms of the payment plan.
Out-of-pocket medical expenses are defined as:
- Annual out of pocket medical expenses incurred by the individual at the hospital that exceed 10% of the patient’s family income in the prior 12 months.
- Annual out of pocket medical expenses that exceed 10% of the patient’s family income, if the patient provides documentation of the patient’s medical expenses paid by the patient or the patient’s family in the prior 12 months.
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