UNMH alters policy on surgeries - Albuquerque Journal

UNMH alters policy on surgeries

For the record: This story has been updated to reflect that a new policy approved by the University of New Mexico Hospital board of trustees allows patients who qualify for its discount program to schedule medically necessary surgery if they pay a co-payment of $300 or less and agree to a payment plan to pay the balance of their medical costs.

Community health advocates say a new billing policy approved by University of New Mexico Hospital officials should allow low-income patients to get nonemergency surgeries they need without having to pay a 50 percent down payment in advance as they had under earlier hospital guidelines.

The new policy, approved last week by the UNMH Board of Trustees, requires that certain uninsured patients can schedule medically necessary surgery if they pay a co-payment of $300 or less and agree to a payment plan to pay the balance of their medical costs.

The new policy “will help patients get health care when they need it, which was the problem with the old policy,” said Sireesha Manne, attorney for the New Mexico Center on Law and Poverty.

Advocates in June jammed a committee room to urge UNMH trustees to change a policy they said denied needed surgeries for low-income patients who could not pay 50 percent of costs in advance.

They said the change had the effect of barring some patients from getting needed surgeries like knee replacements, hysterectomies and hernia surgery without paying thousands in advance, which many patients could not afford.

Advocates attributed the change to “finance guidelines” approved by UNMH officials in May that tightened up payment requirements for patients who needed nonemergency surgeries.

“The board closely examined the issue and recognized that patients were running against this obstacle, and they fixed it,” Manne said Thursday.

Rodney McNeese, UNMH’s director of behavioral health finances, said concerns raised by advocates led trustees to approve a new policy specific to low-income patients who qualify for a 45 percent discount for surgical procedures.

Undocumented immigrants comprise the majority of those discount-eligible patients, who lack insurance or Medicaid and don’t qualify for UNMH financial assistance, he said.

UNMH has treated a total of 12,141 discount eligible patients over the past 12 months, hospital officials said.

The policy approved by trustees on Oct. 27 allows discount-eligible patients to schedule medically necessary surgery after paying a co-payment ranging from $25 to $300 based on assets and income level.

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