HB 79 — An Act establishing requirements for hospital-based financial assistance; providing for hospital-based financial assistance forms, for information about hospital-based financial assistance programs and for reporting of hospital-based financial assistance policies; and imposing duties on the Department of Health.

PRIOR PRINTER'S NO.

30 PRINTER'STHE NO.GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL Session of No.

1326 THE GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL Session of No.

MILLER, GIRAL, HANBIDGE, CIRESI, SANCHEZ, HOWARD, FIEDLER, HADDOCK, POWELL, BOROWSKI, HILL-EVANS, FREEMAN, KENYATTA, DONAHUE, FRANKEL, FLEMING, FRIEL,FREYTIZ, MALAGARI,BOYD, SHUSTERMAN,SIEGEL, PIELLI,O'MARA PASHINSKI,AND CEPEDA-OTTEN, GREEN,JANUARY RABB,10, WAXMAN,2025 D.REFERRED TO COMMITTEE ON HEALTH, JANUARY 10, 2025 AN ACT Establishing the Medical Debt Relief Program;

WILLIAMS,establishing STEELErequirements ANDfor McNEILL,CERRATO,hospital-based JANUARYfinancial 10,assistance; 2025 AS AS AMENDED, APRIL 9, 2025N HEALTH, HOUSE OF REPRESENTATIVES, AN ACT Establishing the Medical Debt Relief Program;

establishing <-- requirements for hospital-based financial assistance;

ESTABLISHING REQUIREMENTS FOR HOSPITAL-BASED FINANCIAL <-- ASSISTANCE;

PROVIDING FOR HOSPITAL-BASED FINANCIAL ASSISTANCE FORMS, FOR INFORMATION ABOUT HOSPITAL-BASED FINANCIAL ASSISTANCE PROGRAMS AND FOR REPORTING OF HOSPITAL-BASED FINANCIAL ASSISTANCE POLICIES;

AND IMPOSING DUTIES ON THE DEPARTMENT OF HEALTH.

This act shall be known and may be cited as the Medical Debt <-- Relief HOSPITAL-BASED FINANCIAL ASSISTANCE Act.

<-- Section 2.

"Bad debt expense." The cost of care for which a health care <-- provider expected payment from the patient or a third-party payor, but which the health care provider or commercial debt collection agency subsequently determines to be uncollectible.

"Eligible resident." An individual eligible for relief who <-- meets all of the following conditions:

"HOSPITAL.""Hospital-based Afinancial NONPROFITassistance." ORFinancial PRIVATEassistance HOSPITALprovided INby THIShospitals <--to COMMONWEALTH.patients that includes charity care or discounted care where the cost of care ordinarily charged by a hospital is provided free of charge or at a reduced rate or a hospital relieves an eligible patient's medical bill in part or in full based on eligibility criteria.

"Hospital-based"Medical financialdebt." assistance."An Financialobligation assistance 20250HB0079PN1326 - 2 - provided by hospitals to patientspay thatmoney includesarising charityfrom care or discounted care where the cost20250HB0079PN0030 of- care2 ordinarily- chargedreceipt by a hospital is provided free of chargehealth orcare atservices. a reduced rate or a hospital relieves an eligible patient's medical bill in part or in full based on eligibility criteria.

"Medical debt." An obligation to pay money arising from the <-- receipt of health care services.

20250HB0079PN1326 - 3 - (b) Use of money.--Money appropriated to the department for the program shall be used exclusively for the program, including contracting with a medical debt relief coordinator and providing money to be used by the medical debt relief coordinator to discharge medical debt of eligible residents.

Money used in contracting with a medical debt relief coordinator may also be 20250HB0079PN0030 - 3 - used for the payment of services provided by the medical debt relief coordinator to discharge medical debt of eligible residents based on a budget approved by the department.

20250HB0079PN1326 - 4 - (iii) After the purchase and discharge of medical debt from a commercial debt collection agency or health care provider, the medical debt relief coordinator shall notify all eligible residents whose medical debt has been discharged under the program, in a manner approved by the department, that they no longer have specified medical 20250HB0079PN0030 - 4 - debt owed to the relevant health care provider or commercial debt collection agency.

(d) Breach of contract.--If a medical debt relief 20250HB0079PN1326 - 5 - coordinator attempts to seek payment from an eligible resident for medical debt purchased by the medical debt relief coordinator or fails to carry out the responsibilities described in its contract with the department, the medical debt relief coordinator shall be considered in breach of contract and the contract provisions that apply in the case of a breach of 20250HB0079PN0030 - 5 - contract shall apply.

(6) The number of and characteristics of medical debt 20250HB0079PN1326 - 6 - relief coordinators contracted with for the purposes of purchasing and discharging medical debt.

20250HB0079PN0030 - 6 - (3) The Speaker of the House of Representatives.

(ii) Information about the limits on amounts and 20250HB0079PN1326 - 7 - type of assets.

20250HB0079PN0030 - 7 - (iv) Contact information for how to apply for hospital-based financial assistance and how to get help applying for hospital-based financial assistance.

(d) Disclosure to patients.-- (1) A hospital shall provide the form discussed in 20250HB0079PN1326 - 8 - subsection (a)(2) to all patients upon intake and discharge.

(2) A hospital shall provide a full copy of its 20250HB0079PN0030 - 8 - financial assistance policies upon request.

20250HB0079PN1326 - 9 - (vi) copies of recent tax returns;

(4) Hospitals may provide hospital-based financial assistance to any patient who is already enrolled in the 20250HB0079PN0030 - 9 - Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants and Children (WIC) or Low-Income Home Energy Assistance Program (LIHEAP), based on presumptive eligibility through use of electronic verification data.

SECTION20250HB0079PN0030 3.- 10 -

HOSPITAL-BASED FINANCIAL ASSISTANCE FORMS.

<-- (A) FORMS.--THE DEPARTMENT SHALL DEVELOP THE FOLLOWING FORMS AND MAKE THEM AVAILABLE TO HOSPITALS AND THE GENERAL PUBLIC:

(1) A UNIFORM APPLICATION FOR FINANCIAL ASSISTANCE THAT SHALL BE USED IN EVERY HOSPITAL IN THIS COMMONWEALTH TO DETERMINE IF AN INDIVIDUAL IS AN ELIGIBLE PATIENT.

(2) A UNIFORM ONE-PAGE TEMPLATE ALL HOSPITALS SHALL USE TO SUMMARIZE EACH HOSPITAL'S ELIGIBILITY INFORMATION FOR HOSPITAL-BASED FINANCIAL ASSISTANCE.

20250HB0079PN1326 - 10 - (3) A BRIEF UNIFORM STATEMENT OF THE AVAILABILITY OF HOSPITAL-BASED FINANCIAL ASSISTANCE AND OF THE APPLICATION FOR HOSPITAL-BASED FINANCIAL ASSISTANCE.

(B) DEVELOPMENT OF FORM.--THE DEPARTMENT SHALL INCLUDE INPUT FROM HOSPITALS AND THE GENERAL PUBLIC IN DEVELOPING THE FORMS DESCRIBED IN SUBSECTION (A)(1), (2) AND (3).

(C) TIME FRAME.--THE DEPARTMENT SHALL DEVELOP THE FORMS WITHIN 180 DAYS OF THE EFFECTIVE DATE OF THIS SUBSECTION.

SECTION 4.

INFORMATION ABOUT HOSPITAL-BASED FINANCIAL ASSISTANCE PROGRAMS.

(A) ACCESSIBILITY OF FORMS.--EACH FORM OUTLINED IN SECTION 3(A) SHALL BE POSTED BY HOSPITALS ONLINE IN A PUBLICLY ACCESSIBLE FORMAT.

A FULL COPY OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICIES SHALL ALSO BE PUBLISHED ALONG WITH THE SUMMARY IN SECTION 3(A)(2).