Code of Massachusetts Regulations
114 CMR - DIVISION OF HEALTH CARE FINANCE AND POLICY
Title 114.6 CMR 10.00 - CRITERIA FOR DETERMINING ELIGIBILITY FOR FREE CARE AT ACUTE CARE HOSPITALS AND FREESTANDING COMMUNITY HEALTH CENTERS
Section 10.08 - Notification
Universal Citation: 114.6 CMR
10.00 MA Code of Regs 10.08
Current through Register 1518, March 29, 2024
Hospitals and Community Health Centers must meet certain criteria regarding notification of the availability of Free Care and other programs of public assistance to patients.
(1) Signs.
(a) Hospitals and Community Health Centers
shall post signs, in the inpatient, clinic, emergency admissions/registration
areas and in business office areas that are customarily used by patients, that
conspicuously inform patients of the availability of financial assistance
programs and the location at the Hospital or Community Health Center to apply
for such programs.
(b) Signs and
print fonts shall be large enough to be clearly visible and legible by patients
visiting these areas.
(c) All signs
and notices shall be translated into language(s) other than English if such
language(s) is primarily spoken by 10% or more of the residents in the
Hospital's or Community Health Center's service area.
(d) Signs must notify patients of the
availability of financial assistance and of the availability of both Free Care
and other programs of public assistance. The following language is suggested,
but not required:
1. "Are you unable to pay
your hospital bills" Please contact a counselor to assist you with various
alternatives." or
2. "Financial
assistance is available through this institution. Please contact
_____________."
(2) Notification Practices.
(a) A Hospital or
Community Health Center will provide individual notice of availability of Free
Care and other programs of public assistance to a patient expected to incur
charges, exclusive of personal convenience items or services, that may not be
paid in full by third party coverage.
(b) A Hospital or Community Health Center or
its designee will include a notice of Free Care availability and other programs
of public assistance in its initial bill.
(c) In all other written collection actions,
a Hospital or Community Health Center or its designee will include a brief
notice of Free Care availability. The following language is suggested, but not
required, to meet the notice requirements of this section: "If you are unable
to pay this bill, please call (phone #). Financial assistance is
available."
(3) Decision letters. Within 30 days of receiving a completed application, a Hospital or Community Health Center must give the applicant written notice of its decision on the application. The decision letter must contain the information that appears below. Samples of decision letters appear in the Free Care application guide.
(a) Free Care approval letters must:
1. explain that the person is eligible for
full Free Care for all Medically Necessary Services, or only Free Care for
Emergency and Urgent Care if the person is not a Massachusetts
resident
2. include the dates of
eligibility
3. list the services
that Free Care does not cover
4.
explain how to re-apply for free care at the end of the eligibility
period
5. include the name and
telephone number of a contact person for more information about Free
Care
6. explain how to file a
grievance with the Division
7.
include the signature of an authorized person.
(b) Partial Free Care approval letters must:
1. explain that the person is eligible for
partial Free Care for all Medically Necessary Services, or only partial Free
Care for Emergency and Urgent Care if the person is not a Massachusetts
resident
2. include the dates of
eligibility
3. include the amount
of the patient Deductible
4. inform
the patient of any required deposit for non-emergency services
5. include information about written payment
plans pursuant to 114.6 CMR 10.05
6. explain how to apply for Medical
Hardship
7. explain how to re-apply
at the end of the eligibility period
8. list the services that Free Care does not
cover
9. include the name and
number of a contact person for more information
10. explain how to file a grievance with the
Division
11. include the signature
of an authorized person.
(c) Medical Hardship approval letters must:
1. explain that the person is eligible for
Medical Hardship for all Medically Necessary Services, or only for Emergency
and Urgent Care if the person is not a Massachusetts resident
2. include the dates of eligibility
3. include the amount of the patient's
Medical Hardship contribution
4.
inform the patient of any required deposit for non-emergency services
5. include information about written payment
plans pursuant to 114.6 CMR 10.05
6. explain how to re-apply at the end of the
eligibility period
7. list the
services that Free Care does not cover
8. include the name and number of a contact
person for more information
9.
explain how to file a grievance with the Division
10. include the signature of an authorized
person.
(d) Free Care
denial letters must:
1. explain why the
patient is not eligible for Free Care or partial Free Care
2. explain how to apply for Medical
Hardship
3. include the name and
number of a contact person for more information
4. explain how to file a grievance with the
Division
5. include the signature
of an authorized person.
(e) Medical Hardship denial letters must:
1. explain why the patient is not eligible
for Medical Hardship
2. include the
name and number of a contact person for more information
3. explain how to file a grievance with the
Division
4. include the signature
of an authorized person.
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