Purpose
The purpose of this policy is to ensure that St. Jude's financial assistance policy is in compliance with federal law, specifically the Patient Protection and Affordable Care Act (PPACA) and applicable regulations.
Scope
This policy applies to all St. Jude departments or divisions that provide services to patients.
Policy
1. Financial Assistance Policy
- Individuals are cared for at St. Jude regardless of ability to pay. All St. Jude patients are eligible to participate in the hospital’s financial assistance program. Individuals are accepted as patients at St. Jude under the New Patient Acceptance Policy (Policy 20.129).
- All services received at St. Jude in all St. Jude departments or divisions are subject to this financial assistance policy.
2. Emergency Medical Care
- St. Jude does not have an Emergency Department, so it does not provide care for emergency medical conditions within the meaning of EMTALA (42 U.S.C. §1395dd). St. Jude provides urgent care to all St. Jude patients, as needed, on a nondiscriminatory basis. St. Jude will not bill or pursue payment from patients for these urgent care services.
Procedure
1. Financial Assistance
- St. Jude patients are not required to apply for assistance; they receive the benefit of this Financial Assistance Policy by virtue of their status as patients. St. Jude currently does not bill nor pursue payment from any St. Jude patient. A billing system is maintained for each patient, but bills are not sent to any patient. If the patient has insurance, the hospital does bill the patient’s health insurance plan, or third party payer. St. Jude covers all treatments, copays, deductibles, and coinsurance and any other cost sharing obligations that are not covered by insurance. St. Jude takes no action to collect from patients or their families and does not report to credit agencies.
2. Emergency Medical Care
- Urgent care may be delivered to existing St. Jude patients in the St. Jude Medicine Room. The St. Jude Medicine Room is open 24 hours a day, 7 days a week, including holidays. Services include but are not limited to providing chemotherapy (cancer-fighting drugs) and blood products, as well as treatment for central line problems, fever, or other acute illnesses and injuries related to the catastrophic diseases treated at St. Jude and consistent with the symptoms of diagnosis and treatment of a patient’s condition, disease, ailment or injury. St. Jude will evaluate patients and others in the St. Jude Medicine Room or elsewhere in the hospital for potential emergencies, initiate treatment and transport them to an emergency department at another hospital when appropriate. If transport of an existing St. Jude patient to a facility with an emergency department is required, St. Jude will bill the patient’s health insurance plan or third party payer if such coverage exists. St. Jude covers all treatments, copays, deductibles, and coinsurance and any other cost sharing obligations that are not covered by insurance, and St. Jude will not bill or pursue payment from St. Jude patients for any services provided by St. Jude to patients, including urgent care services, emergency medical services or transport. St. Jude prohibits any activity that would discourage its patients from seeking emergency medical care.
Definitions
- Emergency medical conditions - a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in: (i) placing the health of the individual in serious jeopardy; (ii) serious impairment to bodily functions; or (iii) serious dysfunction of any bodily organ or part.
- EMTALA - Emergency Medical Treatment and Labor Act