Senate Bill 626
By: Senator Hufstetler of the 52nd
A BILL TO BE ENTITLED
AN ACT
To amend Chapter 7 of Title 31 of the Official Code of Georgia Annotated, relating to
regulation and construction of hospitals and other health care facilities, so as to provide for
certain consumer financial assistance and protections with regard to medical debt arising
from certain healthcare services received by patients at hospitals; to provide a short title; to
provide definitions; to provide for the Department of Community Health to publish on its
website a uniform sample financial assistance policy, screening tool, and application form;
to provide for hospital implementation; to provide for requirements prior to billing; to
provide for compliance; to provide for copayments and deductibles; to provide for notice on
hospital bills; to provide for an appeal of financial assistance eligibility or charity care
determination; to provide for incorrect determination protections; to prohibit certain
financing products; to provide for payment plans; to prohibit debt collection under certain
circumstances; to provide for enforcement; to provide for rules and regulations; to provide
for related matters; to repeal conflicting laws; and for other purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION 1.
Chapter 7 of Title 31 of the Official Code of Georgia Annotated, relating to regulation and
construction of hospitals and other health care facilities, is amended by adding a new article
to read as follows:
<ins>"ARTICLE 17
31-7-450.
This chapter shall be known and may be cited as the 'Georgia Medical Debt Fairness Act.'
31-7-451.
As used in this article, the term:
(1) 'Debt collector' means any person that regularly collects or attempts to collect,
directly or indirectly, debts for another person or entity or uses some name other than its
own when collecting debts.
(2) 'Emergency medical services' means physical or mental health care services rendered
for a medical or traumatic condition, sickness, or injury, including a mental health
condition or substance use disorder, in which a person is exhibiting acute symptoms of
sufficient severity, including, but not limited to, severe pain, regardless of the initial,
interim, final, or other diagnoses that are given, that would lead a prudent layperson
possessing an average knowledge of medicine and health to believe that his or her
condition, sickness, or injury is of such a nature that failure to obtain immediate medical
care could result in:
(A) Placing the patient's health in serious jeopardy;
(B) Serious impairment to bodily functions; or
(C) Serious dysfunction of any bodily organ or part.
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<ins>(3) 'Healthcare services' means services for the diagnosis, prevention, treatment, cure,
or relief of a physical, mental, or behavioral health condition, illness, injury, or disease,
including mental health and substance abuse disorders. Such term includes but is not
limited to emergency medical services or nonemergency medical services and the
provision of pharmaceutical products or services and durable medical equipment or other
devices.
(4) 'Hospital' means a publicly or privately owned hospital licensed pursuant to this
chapter. Such term includes any hospital, nonprofit hospital, or hospital owned or
operated by a hospital authority or a nonprofit corporation formed, created, or operated
by or on behalf of a hospital authority.
(5) 'Medical debt' means an amount owed by a patient to a hospital for healthcare
services received at the hospital or to the hospital's agent or assignee.
31-7-452.
(a) No later than January 1, 2027, the department shall create and post in a prominent
location on its website a uniform sample financial assistance policy, screening tool, and
application form for hospital implementation pursuant to this article.
(b) The uniform financial assistance policy under subsection (a) of this Code section shall
include but not be limited to:
(1) Eligibility criteria for financial assistance and whether such assistance includes
discounted or charity care;
(2) The basis for calculating amounts charged to patients;
(3) The method for applying for financial assistance;
(4) The actions that may be taken in the event of nonpayment; and
(5) The information obtained from sources other than an individual seeking financial
assistance that a hospital may use and whether and under what circumstances a hospital
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<ins>may use prior eligibility determinations to presumptively determine that a patient is
eligible for financial assistance.
(c) Each hospital shall implement financial assistance policies, screening tools, application
forms, and procedures that comply with this article. Any such policy shall apply to all
healthcare services received by a patient at the hospital, unless such services were provided
by an independent healthcare provider that bills separately from such hospital. The
implementation required by this subsection shall apply whether or not a hospital is required
to develop a financial assistance policy under 26 U.S.C. Section 501(r)(4) and
implementing regulations.
31-7-453.
(a) All hospitals, prior to billing a patient receiving healthcare services at such hospital,
shall:
(1) Screen the patient for financial assistance eligibility using a screening tool as
provided for in Code Section 31-7-452; provided, however, that such patient may decline
to provide information to the hospital;
(2) Provide the patient with a financial assistance application form as provided for Code
Section 31-7-452 and offer to assist in completing such form; provided, however, that
such patient may decline to complete such form;
(3) Automatically enroll any such patient who qualifies for financial assistance; and
(4) Automatically apply any discounts available to any such patient.
(b)(1) No hospital shall deliver any bill to a patient receiving healthcare services at such
hospital prior to complying with the requirements provided for in subsection (a) of this
Code section. A hospital shall be deemed compliant with paragraph (1) of subsection (a)
of this Code section if the hospital has screened the patient for financial assistance
eligibility, has updated financial assistance eligibility information on the patient at least
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<ins>once within the calendar year, or has documented that the patient has declined to provide
information to the hospital.
(2) The prohibition provided for in this subsection shall not preclude a hospital from
collecting any copayment or deductible at the time of providing a healthcare service.
(c) Each bill sent to a patient receiving healthcare services at a hospital shall include notice
of the availability of financial assistance, the contact information for the office or
department of the hospital that can provide information about obtaining financing
assistance, and a link to the financial assistance policy for such hospital.
(d) A patient may apply for financial assistance or charity care if such patient was screened
for eligibility and found not to be eligible or was screened and found to be eligible but such
patient disagrees with the amount of charity care.
(e) If a hospital makes an incorrect financial assistance eligibility determination based on
information provided by the patient or available to the hospital at the time of such
determination, such hospital shall:
(1) Credit to such patient's account the amount of charity care for which the patient
qualified and reimburse any other associated reasonable costs incurred by the patient in
securing charity care, including but not limited to reasonable legal expenses and fees; and
(2) If such hospital transferred such patient's medical debt to a debt collector or
authorized a debt collector to collect such debt on behalf of the hospital, such hospital
shall notify such debt collector that such medical debt is no longer valid.
31-7-454.
(a) No hospital shall offer financing products, including but not limited to consumer credit
cards or installment loans, to a patient for medical debt arising from healthcare services
provided at such hospital if such products include an interest rate greater than 1 percent of
such medical debt.
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<ins>(b) A hospital may offer a payment plan to a patient for medical debt arising from
healthcare services provided at such hospital only after the hospital is in compliance with
all provisions in subsection (a) of Code Section 31-7-453 and exhausts all other coverage
and payment options available for such patient; provided, however, that no such payment
plan shall result in fees, late charges, maintenance charges, or interest rate greater than
1 percent of the medical debt for the duration of the medical debt.
31-7-455.
(a) No hospital shall pursue collections against a patient for medical debt arising from
healthcare services provided to such patient at such hospital unless the hospital complies
with all provisions in subsection (a) of Code Section 31-7-453 and exhausts all other
coverage and payment options available for the patient.
(b) No hospital shall pursue collections against a patient for medical debt arising from
healthcare services provided to such patient at such hospital while the patient is appealing
insurance coverage, applying for financial assistance, applying for charity care, appealing
a determination regarding eligibility for or the amount of charity care, negotiating a bill
within such medical debt, or participating in a payment plan offered by the hospital.
31-7-456.
The department shall enforce this article and promulgate rules and regulations required to
administer this Code section."
</ins> SECTION 2.
All laws and parts of laws in conflict with this Act are repealed.