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Health Commission adopts new sliding‑scale and billing rules to limit out‑of‑pocket costs at ZSFG
Summary
The San Francisco Health Commission voted to adopt a resolution revising sliding‑scale charity care, eliminating an asset test for low‑income patients and capping out‑of‑pocket costs — and directing ZSFG to limit charges for insured out‑of‑network patients to the in‑network cost‑sharing amount. The policy took effect Feb. 1, 2019 for new service dates.
The San Francisco Health Commission on a motion and second adopted a resolution revising patient billing and financial assistance policies at Zuckerberg San Francisco General Hospital to reduce balance billing risks and limit patients’ out‑of‑pocket exposure. The changes include in‑network‑parity billing for insured, out‑of‑network patients, income‑tiered caps on out‑of‑pocket payments, expansion of charity care eligibility and elimination of an asset test for the lowest income bracket.
The changes, presented by DPH Chief Financial Officer Greg Wagner, are intended to protect patients who receive care at ZSFG but whose insurance treats the hospital as out of network. "We will bill them no more than they would pay at an in network hospital under their existing plan," Wagner said, explaining the department would still pursue reimbursement from…
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