Los Angeles County, the largest county in the United States — with nearly 10 million residents — is on the cusp of enacting an ordinance that could reshape how hospitals manage and report medical debt. This move, backed by county supervisors, would require hospitals to report every time they initiate debt collection activities to the Los Angeles County Department of Public Health. This includes actions such as phone calls, letters, selling debt to collection agencies, wage garnishments, and reporting to consumer agencies.
The ordinance requires a second vote before it can be officially adopted, which is expected to take place next month.
Specifically, the ordinance would:
- Require all acute care hospitals to submit reports on medical debt and financial assistance;
- Mandate ongoing reports from these hospitals following the initiation of debt collection
- Authorize Public Health to establish regulations for the implementation and enforcement of this Ordinance; and
- Mandate Public Health to provide public data from the information collected
Medical debt reportedly affects one in ten of residents Los Angeles County, who owe a collective $2.9 billion.
The county’s Department of Public Health will begin by collecting data seven hospitals in unincorporated county area — data from accounts that were placed with collection agencies. Hospitals that violate the ordinance would face fines of $5,000 per violation.
If the second vote approves the ordinance, hospitals would have six months before being required to begin submitting reports.
“It would take the reconstructing of medical reporting systems in a lot of cases in hospitals,” said George Green from the Hospital Association of Southern California, in a published report. “For hospitals that are already under-resourced, understaffed, overworked, this could mean additional resources for every single time that a patient is placed into collections.”
Among the information that would be required to be sent to the Department of Public Health would be basic information about the patient without revealing the diagnosis, such as the amount the individual owes to the hospital, when the debt became outstanding, and itemizing payments made by the patient or his or her health insurance.
