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Menu of Suggested Provisions For State Tuberculosis Prevention and Control Laws

Costs

Descriptive Note:  According to the ACET recommendations contained in the article “Tuberculosis control laws—United States,1993: recommendations of the Advisory Council for the Elimination of Tuberculosis (ACET),” published in the Morbidity and Mortality Weekly Report, the inability to pay for medical care (including anti-TB medications) and/or a lack of healthcare insurance should not preclude initiation of an appropriate treatment regimen. Health departments may, however, have the ability to seek payment from third-party payers. This section contains provisions on financing for treatment and costs associated with isolation and detention.

  • Where funds appropriated to the department have been expended for the purpose of meeting the cost of the care, maintenance or treatment of any person who has communicable or infectious tuberculosis pursuant to the provisions of this act and a third party has a legal obligation to pay such cost to or on behalf of the recipient, the [health official] may recover the same from the recipient or from the third party and in all respects shall be subrogated to the rights of the recipient in such cases. Kan. Stat. Ann. § 65-116m (2009).
  • The department should establish a contract with the general hospitals in the larger cities for the care of tuberculosis patients, who do not have a third-party payment source.  The department will pay the standard fee for hospitalization.  The department will only pay for services relevant to the treatment of tuberculosis.  Payment for services above the normal treatment requirements for tuberculosis will be the responsibility of the patient and/or provider. N.D. Admin. Code 33-12-01-02 (2009).
  • The costs incurred by the treatment facility and other providers of services to diagnose or treat the [person who has active tuberculosis or is clinically suspected of having active tuberculosis] must be borne by the [person who has active tuberculosis or is clinically suspected of having active tuberculosis, his/her health plan, or public programs].  During the period of insurance coverage, a health plan may direct the implementation of the care required by the health order or court order and shall pay at the contracted rate of payment, which shall be considered payment in full. Inpatient hospital services required by the health order or court order and covered by medical assistance or general assistance medical care are not billable to any other governmental entity. If the [person who has active tuberculosis or is clinically suspected of having active tuberculosis] cannot pay for treatment, and [he/she] does not have public or private health insurance coverage, [he/she] shall apply for financial assistance with the aid of the county. For persons not otherwise eligible for public assistance, the commissioner of human services shall determine what, if any, costs the [person who has active tuberculosis or is clinically suspected of having active tuberculosis] shall pay. The [health official] shall make payments at the general assistance medical care rate, which will be considered payment in full. Minn. Stat. Ann. § 144.4812 (West 2009).

  • The expenses incurred for detention under [statute authorizing court-ordered detention] or [statute authorizing emergency detention] shall be paid by the individual detained or if the individual is indigent, by the board of county commissioners of the county from which the individual was removed. Ohio Rev. Code Ann. § 339.88 (LexisNexis 2009).

  • Individuals who are isolated at the expense of the Department shall provide the Department with information to determine if any other payment source for the costs associated with isolation is available. Utah Admin. Code r. 388-804-8 (2009).
 
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