In the last few weeks, Attorney General Bob Ferguson has filed lawsuits against two hospitals for failing to provide charity care to low income patients. The lawsuits against St. Joseph Medical Center in Tacoma and Capital Medical Center in Olympia are based on the responsibilities of hospitals in Washington to provide free care to patients below the federal poverty level, and discounted care to patients with incomes up to twice the poverty level.

The law mandates that hospitals have to be proactive at the outset of determining whether a patient is eligible for charity care, and must provide notice in writing to patients that free or discounted care may be available. Hospitals also have the responsibility of interpret the information for patients for whom English is not their first language.

The lawsuit against St. Joes alleges that it has withheld charity care from tens of thousands of low-income patients since 2012. This includes making it harder for patients to get assistance, and billing patients for care that should be free or discounted.

The case against Capital Medical Center alleges that the hospital trained its staff to pressure patients for upfront payments without notifying them of the possibility of charity care or screening them for eligibility. In particular, the law requires that a patient only needs to verify his or her income with one form, such as a pay stub or tax statement. The lawsuit alleges that Capital required up to eight forms to verify income, creating an unnecessary hurdle to receiving charity care.

St. Joes and Capital Medical Center are not the only two hospitals that appear to be failing in this regard. Columbia Legal Services recently released a report on the subject. You can find it here:

[Access Denied: Washington’s Charity Care System, Its Shortfalls, and the Effect on Low-Income Patients](http://columbialegal.org/sites/default/files/170824CharityCareReportFINAL-DIGITAL.pdf)