CA Hospitals Pressed to Tell Patients About Free and Cheaper Care Options

California hospitals were reminded that they must provide written notice to patients – in their native language – of the availability of "charity care" and how to apply.

California Attorney General Rob Bonta has issued a consumer alert after receiving reports that the state's hospitals are ignoring the state’s charity care law obligation to tell patients about free and cheaper care options.

Bonta also sent letters to California hospitals warning them that they must provide written notice to patients – in their native language – of the availability of "charity care" and how to apply.

"When hospitals fail to inform patients of the availability of free or reduced-cost medical care, they force patients and their families to make impossible choices and confront financial hardship," Bonta said. "No family should ever have to think twice about getting their loved one's necessary medical care because they're afraid of high medical costs. Hospitals have a responsibility to inform Californians about their charity care options."

Bonta said the California Department of Justice has received complaints, particularly from rural and farm-working communities across the state, that hospitals are not providing charity care policy notices in a language that patients understand as required by state law.

A media release by CDOJ points to a 2021 survey from Gallup and West Health, showing that one-third of Americans have skipped medical treatment because of the high cost of care.

"As patients continue to face high out-of-pocket costs, they have the right to know that charity care programs exist to help families avoid financial catastrophe," Bonta said.

Those eligible for charity or reduced cost care include:

• Uninsured patients: California law requires hospitals to provide free or discounted care to uninsured patients who earn up to 400% of the federal poverty level.
   
• Insured patients: Californians with health insurance may qualify for discounts if they: (1) earn up to 400% of the federal poverty level, and (2) have faced out-of-pocket medical expenses in the preceding 12 months that exceed 10% of their income.
   
• Immigrants: Californians’ immigration status does not affect eligibility for charity care. Hospitals may request proof of their financial situation — such as pay stubs or documentation from a local social services agency — but only to assess financial eligibility. 

Bonta said Californians have the right to: request payment assistance even if they have health insurance or are undocumented; receive information about charity care and an application for charity care in their native language; receive a written estimate of the out-of-pocket cost they will be expected to pay if they are uninsured; negotiate an extended payment plan to pay for their treatment if they qualify for charity care.

Patients who believe a hospital is violating the law can file a complaint with the California Department of Public Health here.