Common use of Charges for Service Clause in Contracts

Charges for Service. If Contractor charges for its services, it must do so on a sliding fee schedule that is available to the public. Individual annual aggregate charges to clients receiving services must conform to the following limits: Equal to or below official poverty line (OPL) No charges permitted 101% to 200% of OPL 5% or less of Gross Income Level (GIL) 201% to 300% of OPL 7% or less of GIL 300+% of OPL 10% or less of GIL “Aggregate Charges” appliesto annual charges imposed for all servicesregardlessof terminology (i.e. enrollment fees, premiums, deductibles, cost-sharing, co-payments, coinsurance, etc.) and applies to all service providers from whom individuals receive services. A simple application showing annual gross salary of an individual or family shall be used to establish the appropriate level of fees. Contractor must develop consistent and equitable policies and procedures related to verification of patients’ financial status, implementation of a sliding fee scale, and ensuring a cap on patient charges for HIV-related services. In order to comply with these requirements, the Subrecipient may need to provide additional staff training, develop patient education materials, and/or place notices in patient waiting rooms and reception areas. Sliding Fee Scale: Clients cannot be denied care if they are not able to pay for services. RWHAP and TDSHS funded programs must provide a system to discount patient payment for charges by developing and utilizing a sliding discounted fee schedule that is published and made readily available. While the fee schedule may be based on the patient’s income or household size and income, the organization must track the patient’s income and charges imposed. The law prohibits imposing a first-party charge on individuals whose income is at or below 100 percent of the Federal Poverty Level and requires that individuals with incomes above the official poverty level be charged for services. Each Subrecipient is responsible for creating its own sliding fee scale in accordance with the most recent Federal Poverty Level guidelines.

Charges for Service. If Contractor charges for its services, it must do so on a sliding fee schedule that is available to the public. Individual annual aggregate charges to clients receiving services must conform to the following limits: Equal to or below official poverty line (OPL) No charges permitted 101% to 200% of OPL 5% or less of Gross Income Level (GIL) 201% to 300% of OPL 7% or less of GIL 300+% of OPL 10% or less of GIL “Aggregate Charges” appliesto applies to annual charges imposed for all servicesregardlessof services regardless of terminology (i.e. enrollment fees, premiums, deductibles, cost-sharing, co-payments, coinsurance, etc.) and applies to all service providers from whom individuals receive services. A simple application showing annual gross salary of an individual or family shall be used to establish the appropriate level of fees. Contractor must develop consistent and equitable policies and procedures related to verification of patients’ financial status, implementation of a sliding fee scale, and ensuring a cap on patient charges for HIV-related services. In order to comply with these requirements, the Subrecipient may need to provide additional staff training, develop patient education materials, and/or place notices in patient waiting rooms and reception areas. Sliding Fee Scale: Clients cannot be denied care if they are not able to pay for services. RWHAP and TDSHS DSHS funded programs must provide a system to discount patient payment for charges by developing and utilizing a sliding discounted fee schedule that is published and made readily available. While the fee schedule may be based on the patient’s income or household size and income, the organization must track the patient’s income and charges imposed. The law prohibits imposing a first-party charge on individuals whose income is at or below 100 percent of the Federal Poverty Level and requires that individuals with incomes above the official poverty level be charged for services. Each Subrecipient is responsible for creating its own sliding fee scale in accordance with the most recent Federal Poverty Level guidelines.