#8 - Multiple Nominal Charges

In the December 2019, “HRSA-BPHC Consultant eNews”, HRSA provided guidance on using multiple nominal charges based on special population status/funding stream.

The article stated that a common question was whether a health center could have different nominal charges for patients who are identified as being part of a “special population?” An example of this would be whether a health center could apply no nominal charge for its homeless patients but assess a $20 nominal charge to general patient population for the same service?

HRSA explained, that “eligibility for sliding fee discounts, including any nominal charges, is to be based solely on income and family size, not on whether patients are identified as being part of a “special population” or any other demographic category. If a health center chooses to assess a nominal charge for patients with incomes at or below 100% of FPG, or to not assess any nominal charge for services, then this charge or lack thereof, would apply to all patients based on income and family size.”

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