Federal Proposals Would Limit Aggressive Hospital Collections Practices

Margaret Dick Tocknell, for HealthLeaders Media , July 3, 2012

The emergency medical care policy requires hospitals to provide care for emergency medical conditions as defined by the Emergency Medical Treatment and Active Labor Act (EMTALA). The care must be provided regardless of a patient’s FAP eligibility.


In addition, the proposed regulation would limit the hospital charges to FAP eligibles to the "amount generally billed (AGB)" for a patient with health insurance coverage. The AGB could be calculated by a "look-back" method based on actual past claims paid to the hospital facility by either Medicare fee-for-service or a combination of Medicare FFS and private health insurance claims. AGB can also be calculated based on estimates of what Medicare would pay if the FAP-eligible patient was a Medicare FFS beneficiary.

Comments and requests for a public hearing on the Treasury regulations must be received by September 24. The American Hospital Association is expected tp oppose the proposal. In an e-mail exchange with HealthLeaders Media, an AHA spokesperson described the proposed rules as "overly prescriptive" and stated that they "could discourage hospitals’ innovations and best practices."

Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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