Notification

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 shallbe 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 Hospitalor CommunityHealth 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 Hospitalor 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 ofdecisionletters 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.