An Act to address medical debt through hospital financial assistance reform
By Ms. Comerford, a petition (accompanied by bill, Senate, No. 842) of Joanne M. Comerford and Steven Owens for legislation to offer financial assistance for medical debt to those below the federal poverty level. Health Care Financing.
Though nonprofit hospitals are required by federal law to have a written financial assistance policy for their patients, the law gives hospitals discretion in determining their own eligibility criteria and assistance amounts. As such, when uninsured or underinsured Massachusetts residents go to a hospital, there is no guarantee that they will receive financial assistance or that the financial assistance they do receive will be the same at every hospital. This bill standardizes financial assistance policies across hospitals in Massachusetts by establishing a standard eligibility floor, standard discounts, and a uniform financial assistance application.
Section-by-section summary:
Section 1: Adds a new section 69A to Chapter 118 of the General Laws.
(a) Defines terms to be used in this section.
(b) Requires hospitals to develop, implement, and maintain a financial assistance policy for free or discounted care for emergency and medically necessary services, and establishes eligibility criteria and discount levels that every hospital must include in their financial assistance policy.
(c) Specifies that hospitals cannot consider a person’s immigration status or the total cost of services provided, or create a contract that limits a hospital’s ability to provide free or discounted services to an eligible person, when determining eligibility for their financial assistance policy.
(d) Requires hospitals to provide written and verbal notification of their financial assistance policy during a patient’s intake and registration.
(e) Specifies locations where hospitals must post and prominently display notice of their financial assistance policy in any language that is spoken by the lesser of 1,000 individuals or 5 percent of the community served.
(f) Requires hospitals to make their financial assistance policy available on the hospital's website, online patient portals, and electronic or paper billing statements in any language that is spoken by the lesser of 1,000 individuals or 5 percent of the community served.
(g) Requires all hospital billing statements to include the following statement: “You may qualify for free care or a discount on your hospital bill, even if you have insurance. Please contact our financial assistance office at [website] and [phone number].”
(h) Requires hospitals to provide notice to a patient that they can disregard any bills until the hospital has rendered a decision on their financial assistance application, and requires hospitals to establish an appeals process.
(i) Tasks the Executive Office of Health and Human Services and the Health Policy Commission, in consultation with other groups, to develop (i) a uniform financial assistance policy application to be used by each hospital; (ii) guidelines for training relevant staff on the uniform financial assistance policy application and financial policies; and (iii) standards for presumptive eligibility for financial assistance policies based on a person’s eligibility for other state programs.
(j) Requires hospitals to annually report information and patient demographics related to their financial assistance policy to the Center for Health Information and Analysis.
(k) Requires the Health Policy Commission to provide an annual report to the legislature on the use of financial assistance policies and the impact on patients and hospitals.
Section 2: States that subsection (b) of section 1, requiring hospitals to have a financial assistance plan, takes effect 1 year after the effective date of this act.
Section 3: Requires the uniform financial assistance application (noted in subsection (i) above) to be created within 1 year of the effective date of this act.
* The bill summary was created by the Primary Sponsor of the bill; no committee of the General Court certifies the accuracy of its contents.
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