Jackson Health comes under fire for charity care policies

Florida's biggest safety-net hospital puts low-income patients through a bureaucratic ringer in order for them to apply and obtain charity care, Kaiser Health News and the Miami Herald reported.

Jackson Health System has been the subject of administrative complaints to the Internal Revenue Service and the U.S. Department of Health and Human Services due to what appear to be deliberate attempts to bar low-income Floridians from obtaining charity care. The complaints came from Florida Legal Services and the National Health Law Program.

In one example, Miami resident Jacqueline Samuel, who has chronic kidney disease and earns only about $10,000 a year, was denied charity care because she didn't provide signed and notarized affidavits from friends and relatives saying she had been financially dependent on them in the past. Miriam Harmatz, an attorney with Florida Legal Services, told KHN and the Herald that Samuel could not afford the $25 per-page charge to get the documents notarized. "It bothers us that this is how they're treating people. We don't think Jackson is taking the necessary steps to ensure that people really have access."

After being charged $1,640 for a routine blood test, Samuel ceased going to doctors and getting her prescription filled. When Harmatz intervened on her behalf, Jackson Health relented and reinstated her into the charity care program without the notarized documents.

While complainants say Jackson Health has created undue burdens for the poor, hospital officials say they are only undertaking appropriate safeguards. "We're not denying care," Mark Knight, Jackson's chief financial officer, told Kaiser Health News and the Herald. "We're merely asking for validation of what [the applicants] are telling us."

Some hospitals have pulled back on their charity care coverage when patients who qualify for subsidized coverage or Medicaid benefits under the Affordable Care Act (ACA) fail to obtain coverage. However, Florida has not expanded Medicaid under the ACA. That means many low-income patients fall into a zone where they not only can't obtain Medicaid but they also can't receive subsidies to buy coverage on their state's health insurance exchange.

To learn more:
- read the Kaiser Health News/Miami Herald article

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