February 14, 2012 Commissioner Nirav R. Shah, M.D., M.P.H.

New York State Department of Health Corning Tower Empire State Plaza Albany, N.Y. 12237 BY FACSIMILE Re: Hospitals Flout Charity Aid Law, The New York Times, Feb. 13, 2012 Dear Commissioner Shah, I am sure you were as disturbed as I was by yesterdays New York Times article on hospitals widespread failure to comply with the charity care law that went into effect on January 1, 2007. This law addressed the need for financial assistance to reduce the hospital bills of low-income New Yorkers who are uninsured or underinsured. In reviewing the Community Service Societys new report, Incentivizing Patient Financial Assistance, I was appalled to discover how few of our hospitals are complying with the mandates of this law. New Yorks uncompensated care system, the hospital Indigent Care Pool (ICP) program, allocates nearly $1.2 billion in state and federal funds to help those who cannot afford to pay for their hospital care. Yet it appears a significant amount of this money is not being used as intended, and low-income New Yorkers are being penalized. I find myself further dismayed to find that the booklet, Your Rights as a Hospital Patient in New York State, published and distributed by the states Department of Health, makes no reference to the existence of the ICP or any available medical financial assistance for uninsured, low income New Yorkers. All of this highlights for me the importance of both improving our monitoring and regulatory practices to ensure proper compliance with the law and the need to provide better information to patients and the public about their rights.

Given our states financial situation and the current economic climate, it is more important than ever to prevent low-income New Yorkers from being driven further into poverty, or even bankruptcy, because of medical expenses. It is also incumbent upon state government at all levels to ensure proper compliance with the law, especially when public funds such as those allocated to the Indigent Care Pool are at stake. I would appreciate information on how the Department is addressing the concerns raised in this report, and what steps are being taken to ensure that Department materials inform patients of the availability of financial assistance through the Indigent Care Pool and other resources. Sincerely,

Liz Krueger State Senator