Section R9-1-506. Fees Payable by Uninsured Individuals Under a Sliding Fee Schedule

A.      A provider:

1.        Shall not charge an uninsured individual with a family income equal to or less than 100 percent of the current federal poverty guidelines the fee determined according to subsection (C) or subsection (D), and

2.        May charge an individual described in subsection (A)(1) only the single administrative fee determined according to subsection (E).

B.       A provider may charge an uninsured individual with a family income more than 100 percent of the current federal poverty guidelines but not more than 200 percent of the current federal poverty guidelines the fee determined according to subsection (C), subsection (D), or subsection (E).

C.      If a provider uses a sliding fee schedule with fee percentages, an uninsured individual’s fee for medical services shall not exceed the dollar amount calculated by applying the fee per- centage for the individual’s family income to the lowest con- tracted charge for each medical service provided.

D.      If a provider uses a sliding fee schedule with flat fees, an unin- sured individual’s fee for medical services shall not exceed the lowest contracted charge for each medical service provided.

E.       A provider may:

1.        Establish a single administrative fee that does not exceed

$25; and

2.        Charge the administrative fee to:

a.        Uninsured individuals with a family income equal to or less than 100 percent of the current federal pov- erty guidelines; and

b.        Uninsured individuals with family incomes more than 100 percent of the current federal poverty guidelines but not more than 200 percent of the cur- rent federal poverty guidelines only in lieu of the fee calculated under subsection (C) or subsection (D).

Historical Note

New Section made by final rulemaking at 12 A.A.R. 3990, effective December 4, 2006 (Supp. 06-4).