The Hospital Care Assurance Program, or HCAP, offers help with unpaid hospital bills to Ohioans at or below the federal poverty level and who are ineligible for Medicaid coverage.

This program also provides funding to hospitals that have a disproportionately high share of uncompensated care costs for services to indigent and uninsured Ohioans.

HCAP is a state and federal program administered by the Ohio Department of Medicaid.

Finance News – HCAP

Connect here for HCAP-specific Finance News prepared by OHA’s Health Economics & Policy team.

HCAP News

Patients and Families Applying for HCAP

Patients interested in applying for HCAP or patients who have a question about the status of a pending HCAP application should contact the hospital where care was provided. Hospitals manage the application process.

Find Out More About HCAP

Visit our most recent Frequently Asked Questions resource for more detailed information on HCAP free care rules, eligibility requirements, application guidelines, program audits and more.

These FAQs reflect requirements in Ohio Administrative Code (OAC) 5160-2-17 established by the Ohio Department of Medicaid but do not reflect any particular legal interpretation on the part of OHA or ODM and are not intended to provide counsel to consumers about the requirements.

OHA recommends hospitals review their HCAP and other charity care policies and procedures with legal counsel to ensure they are in compliance with all state and federal laws and rules.

FAQs

HCAP and Medicaid Eligibility

OHA reminds hospitals that Ohio Medicaid eligibility guidelines should allow most Ohio residents who qualify for free hospital care to also qualify for full Medicaid benefits. OHA encourages hospitals to ensure each patient has applied for Medicaid as part of the free care application process.

Medicaid DSH Program

The Medicaid Disproportionate Share Hospital program, or DSH, is a vital funding stream for hospitals that serve a high percentage of uninsured, low-income and Medicaid patients. Congress implemented this program in 1981, requiring states to take this disproportion into account when designing state payment systems. In Ohio, the DSH program is known as the Hospital Care Assurance Program, or HCAP. Payments under the HCAP program are supplemental to standard Medicaid hospital payments.

Provider Resources

All public rules and provider manuals are available on the Ohio Department of Medicaid’s website.

• HCAP-related Ohio hospital “free care rule” (OAC 5160-2-17)
• ODM and OHA recommended free care application
• Medicaid-Covered and Non-Covered Revenue Codes (see “ODM Hospital Billing Guidelines,” Appendix I)
• Medicaid Cost Report Information