In a letter responding to one submitted by the American Hospital Association requesting clarification of the federal law implications of offering discounts to uninsured patients, the Secretary of Health and Human Services stated that the Medicare program rules do not prohibit hospitals from providing discounts to uninsured and underinsured patients. The letter, dated February 19, 2004, also emphasized that hospitals can waive copay and deductibles for Medicare beneficiaries based on financial need. The letter was accompanied by a Q&A document, and an additional document prepared by the Office of Inspector General, addressing several issues arising with respect to the discounting of charges, including cost reporting and bill collecting requirements.

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