Pennsylvania 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.

Bill Text

PRIOR PRINTER'S NO. 30 PRINTER'S NO. 1326
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 79
Session of
2025
INTRODUCED BY VENKAT, DAVIDSON, KHAN, KOSIEROWSKI, KUZMA, RIGBY,
TWARDZIK, GUENST, PROBST, ABNEY, D. MILLER, GIRAL, HANBIDGE,
CIRESI, SANCHEZ, HOWARD, FIEDLER, HADDOCK, POWELL, BOROWSKI,
HILL-EVANS, FREEMAN, KENYATTA, DONAHUE, FRANKEL, FLEMING,
FRIEL, MALAGARI, SHUSTERMAN, PIELLI, PASHINSKI, CEPEDA-
FREYTIZ, BOYD, SIEGEL, O'MARA, OTTEN, INGLIS, DEASY, CERRATO,
GREEN, RABB, WAXMAN, D. WILLIAMS, STEELE AND McNEILL,
JANUARY 10, 2025
AS REPORTED FROM COMMITTEE ON HEALTH, HOUSE OF REPRESENTATIVES,
AS AMENDED, APRIL 9, 2025
AN ACT
Establishing the Medical Debt Relief Program; establishing
requirements for hospital-based financial assistance; and
imposing duties on the Department of Health.
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.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as the Medical Debt
Relief HOSPITAL-BASED FINANCIAL ASSISTANCE Act.
Section 2. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
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"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.
"Department." The Department of Health of the Commonwealth.
"Eligible patient." An individual who meets all of the
following requirements:
(1) Is a resident of this Commonwealth.
(2) Can demonstrate an inability to pay the cost of
medical care even after the application of payments for
third-party health coverage.
(3) Provides financial information and documentation
showing that their income and assets make them eligible for
hospital-based financial assistance under the policies of the
hospital and of this act.
"Eligible resident." An individual eligible for relief who
meets all of the following conditions:
(1) Is a resident of this Commonwealth.
(2) Has a household income at or below 400% of the
Federal poverty guidelines or has medical debt equal to 5% or
more of the individual's household income.
"Health care provider." Either of the following:
(1) A health care provider, as defined in section 1201
of the act of May 17, 1921 (P.L.682, No.284), known as The
Insurance Company Law of 1921.
(2) An emergency medical services agency, as defined in
35 Pa.C.S. § 8103 (relating to definitions).
"HOSPITAL." A NONPROFIT OR PRIVATE HOSPITAL IN THIS
COMMONWEALTH.
"Hospital-based financial assistance." Financial assistance
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provided by hospitals to 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.
"Medical debt." An obligation to pay money arising from the
receipt of health care services.
"Medical debt relief." The discharge of a patient's medical
debt.
"Medical debt relief coordinator." A person, company,
partnership or other entity that is able to discharge medical
debt of an eligible resident in a manner that does not result in
a taxable event for the eligible resident.
"Primary language." A language that is the preferred
language for communication during at least 5% of the annual
patient visits by patients who do not have the proficiency in
English necessary to speak, read and write about health care-
related matters.
"Program." The Medical Debt Relief Program established under
section 3.
"Public health coverage option." A program administered by
the Department of Human Services, including Medical Assistance
and the Children's Health Insurance Program, and by the
Pennsylvania Health Insurance Exchange Authority.
Section 3. Medical Debt Relief Program.
(a) Establishment and purpose.--The Medical Debt Relief
Program is established within the department for the purpose of
discharging medical debt of eligible residents by contracting
with a medical debt relief coordinator as described in
subsection (c).
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(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 u