I was in an auto accident a few months ago and the other driver was found to be at 100% at fault and cited accordingly. I do not have health insurance and my auto insurance did not include med pay. Right now I have a lawyer working my case. The hospital I went to sent me information about a program that will help pay up to 100% of my bill. If my bill is paid through this program how does this affect my settlement amount?
It won't have any affect on the amount of your settlement but it may affect the net amount you will receive. That will depend upon whether the program has a right of subrogation (you have to pay the money back if you get money as in a law suit). This is the same right a health insurer would have if it paid the bills. Probably the program administrator would be the best person to ask about the rules. Do tell your attorney.
i am not familiar with what program the hospital is talking about. it sounds like it might be a state program like hoosier helpers. your lawyer should look at it and advise you about it. your lawyer will know this that in indiana evidence of writeoffs on medical bills is now admissable. this could affect the amount of medical bills claimed but at least the bill will be paid. the hospital can also file a hospital lien for the unpaid balance. good luck.
This should not affect your settlement. This would be known as a collateral source and does not affect anything in your settlement. You should consult your attorney, I'm sure he/she would know this answer. If you can't get ahold of your attorney, you should consider hiring one that gives you more attention.
The collateral source rule, or collateral source doctrine, is an American case law evidentiary rule that prohibits the admission of evidence that a victim's damages were or will be compensated from some source other than the damages awarded against the Defendant. For example, in a personal injury action, evidence that the Plaintiff's medical bills were paid by medical insurance, or by Workers' Compensation, is not generally admissible.
The collateral source doctrine has come under attack by "tort reform" advocates. They argue that if the Plaintiff's injuries and damages have already been compensated, it is unfair and duplicative to allow an award of damages against the tortfeasor. As a result numerous states have altered or partially abrogated the rule by statute.
Discounts for Uninsured Patients Who Cannot Afford to Pay Their Hospital Bills
No OIG authority prohibits or restricts hospitals film offering discounts to uninsured patients
Who are unable to pay their hospital bills? It has been suggested that two laws enforced by the
OIG may prevent hospitals film offering discounted prices to uninsured patients. We disagree
And address each law in turn.
The Federal Anti-Kickback Statute.' The Federal anti-kickback statute
Prohibits a hospital from giving or receiving anything of value in exchange for
Referrals of business payable by a Federal health care program, such as Medicare
Or Medicaid. The Federal anti-kickback statute does not prohibit discounts to
Uninsured patients who are unable to vary their hospital bills. However, the
discounts may not be linked in any manner to the generation of business payable
by a Federal health care program. Discounts offered to underinsured patients
Potentially raise a more significant concern under the anti-kickback statute, and
Hospitals should exercise care to ensure that such discounts are not tied directly or
Indirectly to the furnishmg of items or services payable by a Federal health care
Program. As discussed below, the statute and regulations offer means to reduce or
Waive coinsurance and deductible amounts to provide assistance to underinsured
Patients with reasonably verified financial need.
Section 1128@)(6)(A) of the Social Security Act.' This law permits -but does
Not require -the OIG to exclude from participation in the Federal health care
'42 U.S.C. 5 1320a-7b(b).
'42 U.S.C. 5 1320a-7(b)(6)(A).
Programs any provider or supplier that submits bills or requests for payment to
Medicare or Medicaid for amounts that are substantially more than the provider's
or supplier's usual charges. The statute contains an exception for any situation in
Which the Secretary finds "good cause" for the substantial difference. The statute
is intended to protect the Medicare and Medicaid programs -and taxpayers -
From providers and suppliers that routinely charge the programs substantially
more than their other customers.
The OIG has never excluded or attempted to exclude any provider or supplier for
Offering discounts to uninsured or underinsured patients. However, to provide
additional assurance to the industry, the OIG recently proposed regulations that
would define key terms in the statute.~
Among other things, the proposed
regulations would make clear that free or substantially reduced charges to
uninsured persons would not affect the calculation of a provider's or supplier's
"usual" charges, as the term "usual charges" is used in the exclusion provision.
The OIG is currently reviewing the public comments to the proposed regulations.
Until such time as a final regulation is promulgated or the OIG indicates its
Intention not to promulgate a final rule, it will continue to be the OIG's
Enforcement policy that. When calculating their "usual charges" for purposes of
Section 1128&) (6) (A), individuals and entities do not need to consider free or
Substantially reduced charges to (I) uninsured patients or (ii) underinsured ~patients
Who are self-paying patients for the items or services furnis
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