AB 204 — Revises provisions relating to medical debt. (BDR 52-135)

- 83rd Session (2025) – 3 – 2.

Deferring,Any denyingaction that requires a legal or requiringjudicial paymentprocess, beforeincluding, providingwithout medicallylimitation, necessaryplacing care;a lien, except for a lien on a third party settlement, or commencing a civil action;

or 3.

AnyReporting, actionfurnishing that requires a legal or judicialthreatening process,to including,report without limitation, placing a lien, except for a lien on a third party settlement, or commencingfurnish aagency; civil action.

oration regarding a medical debt to a consumer reporting 4.

Garnishing or threatening to garnish the wages of a consumer.

“Financial assistance policy” means a written financial assistance policy of a health care entity which includes:the entity is required to maintain pursuant to section 501(r) of the Internal Revenue Code, 26 U.S.C.

§ 501(r) or the provisions of chapter 439B of NRS, which includes:

The basismethod forused calculatingto determine the amounts charged to patients.patients who are eligible for financial assistance, which must not exceed the amounts generally billed to individuals who have insurance covering such care.

MeasuresSteps the health care entity will take to widelyproactively publicizeinform thepatients policyand withinmembers of the community toabout bethe servedfinancial byassistance thepolicy, healthincluding, carewithout entity.limitation:

financial assistance under the policy on the Internet website of the health care entity;

(b) Making paper copies of the policy available upon request and at locations where the health care entity provides medical services, medical products or medical devices to patients;

and (c) Offering translations of the financial assistance policy and related signage in languages commonly spoken in the area served by the health care entity.

“Medical debt” means a debt owed by a consumer to a health care entity or its agent or assignee for the provision of medical services, medical products or medical devices.

- 83rd Session (2025) – 4 – The term includes, without limitation, medical bills that are not past due or have been paid.

The term does not include:include debt charged to a credit card, as defined in NRS 97A.050.

(a) Debt charged to a credit card, as defined in NRS 97A.050,449.0151.Medical unlessfacility” thehas credit card is issued for the solemeaning purposeascribed ofto purchasingit medicalin services,Sec. products or devices;

or - *AB204_R1* – 4 – (b) An open-end or closed-end extension of credit made by a financial institution to a borrower, unless the open-end or closed- end extension of credit is for the sole purpose of purchasing medical services, products or devices.

Sec.

10.

“Medical facility” has the meaning ascribed to it in NRS 449.0151.

Sec.

“Medical services, medical products or medical devices” means any service, treatment, drug, medication, product or device, excluding cosmetic surgery, that is charged to a consumer by a health care entity.

Sec.Secs.

13.13, 13.3 and 13.7.

1.(Deleted by amendment.) Sec.

A health care entity or collection agency shall not report any information to a consumer reporting agency regarding a medical debt unless the health care entity or collection agency has issued an offer to the consumer to enter into a payment plan to satisfy the medical debt.

For such a payment plan, a health care entity or collection agency must:

(a) Not more than 30 days after the medical debt was incurred, provide to the consumer an itemized bill of all charges for medical services, products or devices at no additional cost to the consumer;

and (b) Not more than 90 days after the medical debt was incurred, provide to the consumer two written offers, provided at least 30 days apart, to enter into a payment plan for which the rate of interest during the payment period on the medical debt is fixed at 0 percent.

2.

If the consumer does not respond to the health care entity or collection agency, or otherwise engage with the health care entity or collection agency to satisfy the medical debt or enter into a payment plan to satisfy the medical debt, the health care entity or collection agency may, not earlier than 90 days after the medical debt was incurred, issue to the consumer a final notice informing the consumer that the medical debt will be reported to a consumer reporting agency not earlier than 180 days after the date on which the notice was issued if the debtor does not enter into a payment plan or otherwise satisfy the medical debt.

3.

If the consumer does not respond to the health care entity or collection agency, or otherwise engage with the health care entity or collection agency to satisfy the medical debt or enter into a payment plan to satisfy the medical debt, within 180 days after the notice was issued pursuant to subsection 2, the health care - *AB204_R1* – 5 – entity or collection agency may report the medical debt to a consumer reporting agency.

4.

If a consumer enters into a payment plan with a health care entity or collection agency:

(a) The terms and conditions of any payment plan between a consumer and a health care entity or collection agency must be specific, intelligible and unambiguous;

(b) The health care entity or collection agency shall fix the rate of interest on the medical debt at 0 percent so long as the consumer complies with the terms and conditions of the payment plan;

and (c) The health care entity or collection agency shall not report any information to a consumer reporting agency regarding the medical debt so long as the consumer complies with the terms and conditions of the payment plan.

5.

Any portion of a medical debt that is reported to a consumer reporting agency in violation of this section shall be void.

6.

The Commissioner of Financial Institutions shall adopt regulations to carry out the provisions of this section, including, without limitation, any additional procedures or requirements governing payment plans which the Commissioner determines are necessary or desirable.

Sec.

Garnishing or threatening to garnish theany wagesrefund of afederal consumerinc5.e tGarnishing, attaching or anyseizing, refundor ofthreatening federalto incomegarnish, taxesattach dueor toseize, a consumer;bank account of a consumer.

or 5.

Garnishing, attaching or seizing, or threatening to garnish, attach or seize, a bank account of a consumer.

- *AB204_R1* – 6 – 2.

(b) Providing a deadline after which such extraordinary collection action will be initiated, which must be not earlier than 30 days after the date of the notice;

and (c)- If83rd theSession medical(2025) debt– was5 incurred– for medical services, products or medical devices provided by a medical facility, stating whether the medical facility offers financial assistance to eligible consumers and providing a plain-language summary of any financial assistance policy of the medical facility.

A health care entity or collection agency shall not engage in any extraordinary collection action against a consumer for a medical debt during any period in which, within respectany topart of the geographiccounty areain this State in which the consumer resides, there exists:

or (c) A state of emergency, declaration of disaster or public health emergency as declared pursuant to federal law orwhich thehas lawsbeen ofin anothereffect state.for less than 6 months.

4.

Any statute of limitations applicable to a claim to recover health care entity or collection agency is prohibited from engaging in any extraordinary collection action pursuant to subsection 3.

If a medical debt was incurred for medical services, medical products or medical devices provided by a medicalhealth facility,care entity, the medicalhealth facilitycare entity or a collection agency shall not engage in any extraordinary collection action to recover the medical debt unless such extraordinary collection action is described in the billing and collections policy of the medicalhealth facility.care entity.

If a medicalhealth facility,care entity, or a collection agency acting to collect a medical debt incurred for medical services, medical products or medical devices provided by a medicalhealth facility,care entity, initiates an extraordinary collection action against a consumer to collect a medical debt and the consumer is later found to be eligible under the financial assistance policy of the medicalhealth facilitycare for financial assistance that eliminates or would have eliminated the medical debt, the medicalhealth facilitycare entity or collection agency shall reverse any such extraordinary collection action, including, without limitation, removing any lien, attachment or garnishment against the property of the consumer.

If, after the application of any financial assistance for which a consumer is eligible, the consumer has paid, to a medicalhealth facility,care entity, a collection agency or both, an amount in excess of the amount of the medical debt, the medicalhealth facilitycare entity or collection - *AB204_R1*83rd Session (2025) – 76 – agency shall refund any excess amount to the consumer within 60 days.

If(Deleted theby Commissioneramendment.) ofSec. Financial Institutions has reason to believe that a person has willfully violated, is violating or is about to violate any of the provisions of sections 2 to 18, inclusive, of this act, the Commissioner may institute an appropriate legal proceeding against the person.

The district court, upon a showing that the person has willfully violated, is violating or is about to violate any provision of sections 2 to 18, inclusive, of this act may grant any of the following remedies, as appropriate:

1.

Issue a temporary or permanent injunction.

2.

Impose a civil penalty not to exceed:

(a) For a first violation, $10,000;

and (b) For any subsequent violation, $25,000.

3.

Issue a declaratory judgment.

4.

Order restitution for the consumer.

5.

Order the payment of attorney’s fees and costs.

6.

Order such relief as the court deems just.

Sec.

Take any confession of judgment or any power of attorney running to the collection agency or to any third person to confess judgmentjud2.entCommence ora civil action to appearcollect forthe medical debt if the debtoramount of the medical debt, excluding interest, late fees, collection costs, attorney’s fees and any other fees or costs, is less than the maximum jurisdictional amount set forth in asubsection judicial1 proceeding.of NRS 73.010.

2.

Commence a civil action to collect the medical debt if the amount of the medical debt, excluding interest, late fees, collection costs, attorney’s fees and any other fees or costs, is less than the maximum jurisdictional amount set forth in subsection 1 of NRS 73.010.

- *AB204_R1* – 8 – (b) Medical debt incurred before, on or after January 1, 2026, but do not apply to any action taken to collect a medical debt before January 1, 2026.

(a) “Collection agency” has the meaning ascribed to it in section 3 of this act.

(b) “Health care entity” has the meaning ascribed to it in section 8 of this act.

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