This section applies to financial assistance programs provided by hospitals to qualifying patients, including program requirements specific to charity care.
1.Definitions.
As used in this section, unless the context otherwise indicates, the following terms have the following meanings.
2.Hospital to provide charity care.
A hospital shall, in accordance with rules adopted by the department, provide free health care services to eligible patients who are state residents in accordance with this section. Upon admission of a patient, or in cases of emergency admission before discharge of a patient, a hospital shall investigate the coverage of the patient by any insurance or state or federal programs of medical assistance. A hospital shall provide free, medically necessary services for patients
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This section applies to financial assistance programs provided by hospitals to qualifying patients, including program requirements specific to charity care.
1.
Definitions.
As used in this section, unless the context otherwise indicates, the following terms have the following meanings.
2.
Hospital to provide charity care.
A hospital shall, in accordance with rules adopted by the department, provide free health care services to eligible patients who are state residents in accordance with this section. Upon admission of a patient, or in cases of emergency admission before discharge of a patient, a hospital shall investigate the coverage of the patient by any insurance or state or federal programs of medical assistance. A hospital shall provide free, medically necessary services for patients whose family income is equal to or less than 200% of the federal poverty level.
3.
Applications and eligibility requirements for financial assistance programs generally.
The following requirements apply to financial assistance programs provided by a hospital, including charity care except as otherwise provided in subsection 4. A hospital, in accordance with rules adopted by the department:
4.
Applications and eligibility requirements specific to charity care.
In addition to the requirements of subsection 3, and notwithstanding any provision of subsection 3 to the contrary, the following requirements apply to charity care. A hospital, in accordance with rules adopted by the department:
5.
Notice and publication requirements.
In accordance with rules adopted by the department, a hospital shall widely publicize its financial assistance programs within the community served by the hospital, including by:
6.
Individual written notice of charity care availability.
A hospital shall provide a patient with individual written notice of the availability of charity care according to the following.
7.
Patient notified of noncovered services; consequences for failing to notify.
In accordance with rules adopted by the department, a hospital shall inform a patient who is determined to be eligible for financial assistance if any part of a medical service, treatment, procedure or test provided or administered to the patient in the hospital is not covered by the hospital's financial assistance programs. A hospital may not bill a patient for a medical service, treatment, procedure or test if the hospital failed to provide the patient with advance notice that a medical service, treatment, procedure or test is not covered under the hospital's financial assistance programs. A hospital may bill a patient's health insurance carrier for a medical service, treatment, procedure or test for which the hospital is prohibited from billing the patient under this subsection.
8.
Reasonable payment plans; maximum out-of-pocket payments.
In accordance with rules adopted by the department, a hospital shall offer a patient with a documented family income that does not exceed 400% of the federal poverty level a payment plan that requires monthly out-of-pocket payments that do not exceed 4% of the patient's monthly family income that is not exempt from attachment or garnishment under state law.
9.
Bill disputes.
A hospital shall include on a billing statement sent to a patient information regarding how to dispute a charge. If the contact information for disputing a charge is distinct from the contact information for paying or otherwise settling a bill, the contact information for the individual or entity charged with handling disputed charges must be provided.
10.
Online application for charity care.
A hospital shall, by July 1, 2028, provide an online option through which an applicant may file an application for charity care. The online option must provide for an e-mail response to the applicant that the application has been received. The hospital shall provide an option for a patient to request that an application be mailed to the patient.
11.
Enforcement.
This subsection governs enforcement of this section.
12.
Application developed by department.
The department shall develop an application for patients to apply for financial assistance programs, including charity care, consistent with the requirements of subsections 3 and 4, as applicable. The department shall translate any application it develops into any language spoken by 5% of the population of the State or 1,000 people in the State, whichever is less.
13.
Rulemaking.
The department shall adopt rules to carry out the purposes of this section. Rules adopted pursuant to this section must be consistent with the requirements of the United States Internal Revenue Code of 1986, Section 501(r) and any federal regulations implementing those requirements. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A.