Senate committee presses pause on charity-care reporting bill after public testimony

House Bill 606, a proposal to change how hospitals report charity care in Virginia, was carried over by the Senate committee after extended questioning and public testimony.

The presiding senator and committee members pressed staff on how prior changes to the charity-care calculation — adopted roughly seven to eight years ago — shifted the method to a Medicare-evaluation basis that staff said has made annual reporting effectively nondeterminative. Committee staff explained that returning to a gross patient charges methodology would likely make it possible for facilities to file required reports and allow state entities to analyze charity-care levels across providers.

Rufus Phillips, who identified himself as CEO of the Virginia Association of Free Clinics, told the committee that "right now, no charity care reporting is occurring because of the Medicare evaluation being too complex," and that "by replacing it with gross patient charges, it will allow facilities to more easily report their charity care," enabling state-level analysis and oversight.

Senator Deeds and others asked follow-up questions about the fiscal and operational impacts on hospitals and on free clinics. Staff cautioned that shifting definitions and calculations could require hospitals to free up funds or change internal accounting practices, and that additional information was needed to understand the full consequences and any unintended fiscal effects.

After discussion, the committee approved a motion to carry HB 606 over for additional information and requested a letter and further review (including stakeholder input) before taking a final vote.

The committee did not adopt or defeat the bill at this meeting; next steps are additional analysis and resubmission for committee consideration.