Anderson Cancer Center

Non-profit hospital tax breaks attacked by Grassley, again

Wed, 11 Jun 2008 06:59:56 -0400

Well, folks, if you thought Sen. Chuck Grassley (R-Iowa) was ready to take a breather on the subject of non-profit hospital tax breaks, think again. This week, the Senator used a hearing on incentives for lowering the rates of the uninsured and under-insured in the U.S. to bring the topic up again. At the hearing, which was held by the Senate Finance Committee, Grassley had a 53-year-old leukemia patient testify about her experience with the M.D. Anderson Cancer Center, which demanded a total of $105,000 in cash up front before it would provide chemotherapy.

In discussing the issue, Grassley noted that M.D. Anderson is a non-profit "funded through taxpayers' dollars and charitable gifts," making its actions particularly troubling. As he has many times in the past, Grassley hinted that non-profit tax breaks could be in danger if the hospitals engage in this type of billing practice.

Among other things, Grassley has also proposed that rules be enacted to set minimum levels of charitable spending a not-for-profit would be required to make to keep its tax-free status. Meanwhile, the IRS is taking a closer look at such issues as it rolls out its Form 990, Schedule H, which will require detailed reporting on charitable spending by hospitals.

To learn more about Grassley's discussion at the hearing:
- read this Wall Street Journal blog item

Related Articles:
Senator may seek tougher charity rules for nonprofits
Senator wants nonprofit hospital investigation
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Charity care under fire

Hospital services pre-payment may loom large in future

Fri, 09 May 2008 06:59:59 -0400

Recently, we've covered a variety of news that touched on the issue of whether hospitals should get tough about collecting from patients prior to delivering care for elective procedures. Most of it suggests that this is a risky strategy, at least politically:

* The Wall Street Journal ran a very unflattering piece on the M.D. Anderson Cancer Center's decision not to treat a leukemia patient until she coughed up $100,000 in cash.

* Perhaps in response to the WSJ story--or others like it--the Minnesota legislature just passed a measure forbidding the state's hospitals from investigating a patient's medical debt prior to treating them.

* According to one blog, an ED surgeon recently was sued under EMTALA because he gave a patient a realistic estimate of costs during treatment and the patient went elsewhere.

This is a difficult situation, and it's going to get nastier, particularly if reform-minded types take over the White House this year. Why? Because historically, hospitals have been asked to carry many of the costs of system, and policy-makers don't always bear in mind that they don't have the resources.

On the other hand, hospitals aren't completely helpless. As our sister publication, FierceHealthFinance, points out, hospitals often can do much more to qualify patients for various forms of charity care and public assistance, as well as collect from self-pay patients after the fact. That, at least, is a start.

Other than that, I suspect it's time for even the least politically minded hospital executives among us to become active. Make your case on the local, state and even federal level. Otherwise, our political leaders may continue to assume--as some seem to now--that you're the bad guys. - Anne

Hospitals requiring upfront cash payments

Tue, 29 Apr 2008 06:59:57 -0400

Of late, a growing number of hospitals--including not-for-profits--have been insisting on cash payments before they offer services to non-emergency patients. While it may not generate the best PR, it's a matter of survival, hospitals say. Uncompensated care has been flattening hospitals nationwide, with the burden climbing 44 percent in 2006, to $31.2 billion, from $21.6 billion in 2000. Hospitals are being sapped by care for growing numbers of uninsured patients, and say that unless they get tough on patients with some means, some of them simply won't survive. However, such a strategy can rebound when not-for-profits take this stand. For example, this week the Wall Street Journal brought some unflattering attention to the M.D. Anderson Cancer Center, which in late 2006 asked a leukemia patient for $105,000 up front because it wasn't satisfied with her insurance coverage.

To learn more about this trend:
- read this Kaiser Daily Health Policy Report item

Related Articles:
In 2007, bad debt rising for hospitals
In 2006, uncompensated care costs level out
Bad debt savages HCA, LifePoint profits
HCA sees debt rising until patients get insured