Los Angeles County wants to require hospitals to notify before pursuing medical debt collection

The Board of Supervisors is expected to have a final vote to decide whether hospitals should inform the county at least a month in advance before starting their debt collection process.

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Los Angeles County is considering a new medical debt ordinance that aims to ensure people with outstanding medical bills are getting financial assistance while mandating hospitals located in the unincorporated areas of the county to be transparent about debt collection.

The Board of Supervisors is expected to vote for the second time in the coming weeks on the ordinance, which would also require hospitals to inform the county at least a month in advance before starting their debt collection process. 

The report to the county would entail basic information about the patient without revealing the diagnosis, what the original amount the person owes to the hospital and when the debt became outstanding as well as the itemization of payments by the patient or insurance.

Public health officials said the new rules would help low-income families who are drowning in medical bills as almost half of the people with outstanding medical debt appear to “live below 200% of the federal poverty level.” Public Health Director Barbara Ferrer.

"Medical debt does remain a crucial public health issue in LA County that’s affected approximately one in 10 adults," Ferrer said.

Supporters of the rules said the burden of medical bills are weighing heavy on working families.

“One fellow volunteer's mom was a single parent who had to work 80 hours a week to provide for four teenagers,” Kira Sano, a youth advocate from the American Cancer Society said. “After hiding her diagnosis of multiple melanoma for years from her children to protect them, she passed away within a few weeks of being hospitalized.”

But critics worry, while the cost of implementing could vary from hospital to hospital, reporting the data for individual patients would require more than just paperwork.

"It would take the reconstructing of medical reporting systems in a lot of cases in hospitals,” George Green from the Hospital Association of Southern California said “For hospitals that are already under-resourced, understaffed, overworked, this could mean additional resources for every single time that a patient is placed into collections.”

But Dr. Anish Mahajan with the Department of Public Health argued that the information that would be required for the mandated reports should be already available to hospitals. 

“It's data that they already use for billing,” Mahajan said. “It's data they already use for debt collection, and we're just asking for a copy of it sent to us as well.”

Several hospitals in the unincorporated areas would be subjected to adjust their debt collection policies under the ordinance, but local cities could also choose to adopt the new rules. 

Any hospital that violates the ordinance may be fined up to $5,000 with possible additional fines for non-compliance. 

Collecting medal debt data is part of a $5 million pilot program, which was approved this year as the county aims to buy and settle $500 million in debt for low-income earners, Supervisor Janice Hahn’s office said.

A final vote on the debt reporting ordinance is expected to take place in September. If approved, hospitals would have six months before the data reports are due.

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