Act by Sept. 8: Proposed DOH Rule Would Impose Charity Care Requirements on Physician Groups

The Department of Health is proposing a new rule that if adopted would impose charity care requirements on all physicians delivering care in hospital settings. While the WSMA acknowledges the impact that the cost of healthcare can have on patients, we strongly oppose this rule. Applying charity care requirements to physician groups would be unprecedented, inappropriate, unworkable, and in our analysis not in accordance with state law.

Time is of the essence to engage on this rule proposal—the deadline for comment is midnight on Tuesday, Sept. 8. If you have concerns you want to share with the Department of Health about this rule, you can email charitycare@doh.wa.gov. The WSMA is finalizing our formal comment and if your physician group would like to sign on you can email WSMA Senior Director of Government Affairs & Policy Sean Graham.

Time is of the essence to engage on this rule proposal—the deadline for comment is midnight on Tuesday, Sept. 8.

For background, charity care requirements have been in place for hospitals for decades and specific standards in our state were set by the Legislature in 1989. Washington state law is clear in applying charity care requirements to hospitals. But in implementing recently passed bills, the Department is expanding the obligation to provide charity care to all “medically necessary” care that is delivered in a hospital, including the professional fees charged by physicians and nonphysician healthcare providers.

The WSMA is unaware of any other state that extends charity care requirements to physician groups. It’s inappropriate to do so as the business operations of hospitals and physician groups are not analogous. It’s unclear how physician groups would comply with the law as all state regulations are hospital specific. And it appears to be out of accordance with state law that specifically and exclusively requires hospitals to provide charity care.

The financial challenges that patients face in paying hospital bills are real, and the WSMA is always willing to constructively engage on proposals to promote affordability. But many hospital-based physician groups are already struggling to remain viable and will not be able to write off financial losses associated with charity care as a hospital can. Counter to its intent, the rule may end up diminishing access to care if physician groups fold or consolidate into larger systems.

Next steps and questions

We encourage impacted WSMA members to comment on the rule by midnight, Sept. 8 or reach out to WSMA staff to learn more. If your physician group would like to sign on to WSMA’s formal comment, email WSMA Senior Director of Government Affairs & Policy Sean Graham. Full details on the rulemaking are available here.