Prepare for charges and have a response ready

Jay Wolfson, DrPH, JD, professor of health care law, finance, and policy at the Colleges of Public Health and Medicine at the University of South Florida in Tampa, offers this advice on how to counter not-for-profit lawsuits and avoid becoming a target for similar allegations:

1. Perform comprehensive, valid analyses of existing billing and collection practices.

2. Develop targeted training and education programs for intake, billing, and collections staff. Improving your billing practices is a good way to improve your institution’s image. Better intake will help identify actual and potential sources of payment. Make use of existing alternatives within the community to assist uninsured patients. Medicaid, local community health plans, and health plans for children should all be explored. As much as possible, make arrangements in advance with patients and families regarding the payment of bills.

3. Identify alternative, flexible means by which to accommodate bona fide, medically indigent patients. One method is to arrange for patients to acquire credit cards with banks so that the collection is divorced from the health care institution. You also should consider making flexible arrangements when patients request assistance to allow for longer term, smaller payments, without interest.

4. Identify alternative sources of funding services to the medically indigent.

5. Perform comprehensive, valid analyses of charity care, community benefits, and tax-exempt related activities.

6. Catalogue and analyze the scope of specific things you do that quality as "community benefit" and let the community know you do these things.

7. Fill the gap between tax benefits enjoyed and measurable community services provided.

8. Develop clear and uncompromised responses to these allegations:

  • You use public monies to compete against other providers.
  • You create additional, unneeded, expensive medical technology in the community.
  • You contribute to higher costs of unnecessary services and inappropriate care.
  • You detract from public funds that could be used to support education, public safety, transportation, and other community needs.