Current through Register Vol. 24-18, September 15, 2024
All hospitals shall, within ninety days of the adoption of
these rules, implement a sliding fee schedule for determination of discounts
from billed charges for responsible parties meeting the criteria in WAC
246-453-040(2).
These sliding fee schedules must be made available upon request.
(1) In developing these sliding fee
schedules, hospitals shall consider the following guidelines:
(a) The sliding fee schedule shall consider
the level of charges that are not covered by any public or private sponsorship
in relation to or as a percentage of the responsible party's family
income;
(b) The sliding fee
schedule shall determine the maximum amount of charges for which the
responsible party will be expected to provide payment, with flexibility for
hospital management to hold the responsible party accountable for a lesser
amount after taking into account the specific financial situation of the
responsible party;
(c) The sliding
fee schedule shall take into account the potential necessity for allowing the
responsible party to satisfy the maximum amount of charges for which the
responsible party will be expected to provide payment over a reasonable period
of time, without interest or late fees; and
(d) Hospital policies and procedures
regarding the sliding fee schedule shall specify the individual financial
circumstances which may be considered by appropriate hospital personnel for
purposes of adjusting the amount resulting from the application of the sliding
fee schedule, such as:
(i) Extraordinary
nondiscretionary expenses relative to the amount of the responsible party's
medical care expenses;
(ii) The
existence and availability of family assets, which may only be considered with
regard to the applicability of the sliding fee schedule;
(iii) The responsible party's future income
earning capacity, especially where his or her ability to work in the future may
be limited as a result of illness; and
(iv) The responsible party's ability to make
payments over an extended period of time.
(2) Examples of sliding fee schedules which
address the guidelines in the previous subsection are:
(a) A person whose annual family income is
between one hundred one and two hundred percent of the federal poverty
standard, adjusted for family size, shall have his/her hospital charges that
are not covered by public or private sponsorship limited to forty percent of
the excess of that person's annual family income over one hundred percent of
the federal poverty standard, adjusted for family size. This responsibility may
be adjusted by appropriate hospital personnel after taking into consideration
the individual financial circumstances of the responsible party. The
responsible party's financial obligation which remains after the application of
this sliding fee schedule may be payable in monthly installments over a
reasonable period of time, without interest or late fees, as negotiated between
the hospital and the responsible party.
(b) A person whose family income is between
one hundred one and two hundred percent of the federal poverty standard,
adjusted for family size, shall have his/her hospital charges that are not
covered by public or private sponsorship reduced according to the schedule
below. The resulting responsibility may be adjusted by appropriate hospital
personnel after taking into consideration the individual financial
circumstances of the responsible party. The responsible party's financial
obligation which remains after the application of this sliding fee schedule may
be payable in monthly installments over a reasonable period of time, without
interest or late fees, as negotiated between the hospital and the responsible
party. The schedule is as follows:
|
INCOME AS A
PERCENTAGE
OF FEDERAL POVERTY
LEVEL
|
PERCENTAGE DISCOUNT
|
|
One hundred one to
one hundred thirty-three
|
Seventy-five percent
|
|
One hundred thirty-four to
one hundred sixty-six
|
Fifty percent
|
|
One hundred sixty-seven to
two hundred
|
Twenty-five percent
|
(3) The provisions of this section and
RCW
70.170.060(5) shall not
apply to the professional services of the hospital's medical staff, provided
that the charges for such services are either submitted by the individual
medical staff or are separately identified within the hospital's billing
system.
Statutory Authority: Chapters 43.070 [43.70 ] and 70.170
RCW. 94-12-089, § 246-453-050, filed 6/1/94, effective 7/2/94. Statutory
Authority:
RCW
70.170.060. 91-05-048 (Order 142), §
246-453-050, filed 2/14/91, effective
3/17/91.
