California attorney general scolds hospitals for withholding charity care policy info from patients

California is warning hospitals to be more upfront about their charity care and discount policies following complaints that facilities are not adequately informing patients as required by state law.

In letters sent to the state’s hospitals on Tuesday, California Attorney General Rob Bonta said the complaints came “particularly from rural and farm-working communities.”

Bonta stressed legal requirements that hospitals’ policy notices must be provided “in a language that patients understand,” so long as that language is spoken by at least 5% of patients served by the hospital.

“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 in a statement. “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.”

The attorney general’s letters also referenced complaints from California communities regarding charges for COVID-19-related treatment they could not afford as well as the receipt of “significant medical bills” for related care.

No specific hospitals or health systems were named by Bonta’s office in the uploaded letters, announcements or related documents.

Per California law, hospitals must provide written notices of their charity or discount care policies to all hospital patients, including outpatient and emergency room patients. These notices must be provided at the time of service if the patient is able, but no later than during discharge or when the patient leaves the facility.

Bonta’s office paired the warning letters with a consumer alert informing California residents of their rights to free or reduced-cost care, including eligibility or application instructions.

Californians without health insurance are eligible if they earn up to 400% of the federal poverty level, according to the consumer alert. Those with health insurance coverage may qualify if they are within the 400% federal poverty threshold and have also received out-of-pocket medical expenses exceeding 10% of their income within the past 12 months. Immigration status does not affect eligibility.

The attorney general’s office also encouraged Californians to file a complaint with the California Department of Public Health if they believe a hospital is violating the state’s charity care law.