The first meeting of the NYS Bad Debt and Charity Care (BDCC) Pool Technical Advisory Committee (TAC) was held on June 13. The TAC, which was formed as a result of the State fiscal year (SFY) 2007-08 budget to advise the Commissioner of Health as he evaluates the type and amount of services that New York hospitals provide to indigent patients, costs incurred by hospitals in relation to their distributions from the BDCC pool, and the relationship between the BDCC pool distributions and the hospitals' obligation under the patient financial aid law. The Commissioner must submit a report by Dec. 15, 2007, with his evaluation and recommendations for pool restructuring. The report is expected to form the basis for proposals to restructure the BDCC pool distribution methodology in the SFY 2008-09 budget. 

The TAC comprises CFOs from hospitals, including several from the GNYHA membership, as well as representatives from the Legislature and consumer advocates, and other technical experts. At the meeting, Department of Health (DOH) staff briefed the TAC on the current BDCC pool distribution methodology and the requirements of the patient financial aid law, and posed questions to the TAC about how hospitals compile and report data for the purpose of receiving distributions from the BDCC pool. In particular, the discussion focused on how hospitals differentiate between bad debts and charity care for reporting purposes and the complexities of obtaining patient financial information from individuals needed to make a determination as to the patient's indigent status, especially when emergency services were provided. In addition, TAC members discussed the limitations of the patient accounting systems and stringent audit requirements that make separating bad debt and charity care difficult. In response to concerns about the patient accounting systems limitations raised by hospital members, GNYHA has initiated conversations with several of the largest vendors of such systems in order to explore changes that would be needed to improve hospital reporting, with a focus on differentiating between bad debts and charity care. 

DOH will hold public hearings over the summer on this issue in NYC and Syracuse to gather input from other stakeholders. The TAC will meet again in September and November to discuss possible reforms of the BDCC pool distribution methodology and their recommendations to inform the Commissioner's report. GNYHA will continue to work with its members, HANYS, and others to provide appropriate feedback to DOH.