§ 23-17-67. Hospital determinations for Medicare and Medicaid for uninsured patients.
(a) All hospitals shall screen each uninsured patient, upon the uninsured patient's agreement,
at the earliest reasonable moment for potential eligibility for both:
(1) Public health insurance programs; and
(2) Any financial assistance offered by the hospital.
(b) All screening activities, including initial screenings and all follow-up assistance,
shall be provided in compliance with § 23-17-54.
(c) If a patient declines or fails to respond to the screening described in subsection
(a) of this section, the hospital shall document in the patient's record the patient's
decision to decline or failure to respond to the screening, confirming the date and
method by which the patient declined or failed to respond.
(d) If a patient does not decline the screening described in subsection (a) of this section,
a hospital shall screen an uninsured patient at the earliest reasonable moment.
(e) If a patient does not submit to screening, financial assistance application, or reasonable
payment plan documentation within thirty (30) days after a request, the hospital shall
document the lack of received documentation, confirming the date that the screening
took place and that the thirty-day (30) timeline for responding to the hospital's
request has lapsed; provided, however, that it may be reopened within ninety (90)
days after the date of discharge, date of service, or completion of the screening.
(f) If the screening indicates that the patient may be eligible for a public health insurance
program, the hospital shall provide information to the patient about how the patient
can apply for the public health insurance program, including, but not limited to,
referral to healthcare navigators who provide free and unbiased eligibility and enrollment
assistance, including healthcare navigators at federally qualified health centers;
local, state, or federal government agencies; or any other resources that the state
recognizes as designed to assist uninsured individuals in obtaining health coverage.
(g) If the uninsured patient's application for a public health insurance program is approved,
the hospital shall bill the insuring entity and shall not pursue the patient for any
aspect of the bill, except for any required copayment, coinsurance, or other similar
payment for which the patient is responsible under the insurance. If the uninsured
patient's application for public health insurance is denied, the hospital shall again
offer to screen the uninsured patient for hospital financial assistance, and the timeline
for applying for financial assistance under this section shall begin again.
(h) A hospital shall offer to screen an insured patient for hospital financial assistance
under this section if the patient requests financial assistance screening; if the
hospital is contacted in response to a bill; if the hospital learns information that
suggests an inability to pay; or if the circumstances otherwise suggest the patient's
inability to pay.
(i)(1) Each hospital shall post a sign with the following notice: "You may be eligible for
financial assistance under the terms and conditions the hospital offers to qualified
patients. For more information contact [hospital financial assistance representative]�.
(2) The sign under subsection (i)(1) of this section shall be posted, either by physical
or electronic means, in accordance with § 23-17-54.
(3) Each hospital that has a website shall post a notice in a prominent place on its website
that financial assistance is available at the hospital, a description of the financial
assistance application process, and a copy of the financial assistance application.
(4) Within one hundred eighty (180) days after January 1, 2025, each hospital shall make
available information regarding financial assistance from the hospital in the form
of either a brochure, an application for financial assistance, or other written or
electronic material in the emergency room, hospital admission, and registration area.
(j)(1) The executive office of health and human services is responsible for administering
and ensuring compliance with this section, including the development of any rules
and regulations necessary for the implementation and enforcement of this section.
(2) The executive office of health and human services shall develop and implement a process
for receiving and handling complaints from individuals or hospitals regarding possible
violations of this section.
(3) The attorney general may conduct any investigation deemed necessary regarding possible
violations of this section by any hospital including, without limitation, the issuance
of subpoenas to:
(i) Require the hospital to file a statement or report or answer interrogatories in writing
as to all information relevant to the alleged violations;
(ii) Examine under oath any person who possesses knowledge or information directly related
to the alleged violations; and
(iii) Examine any record, book, document, account, or paper necessary to investigate the
alleged violation.
(4) If the attorney general determines that there is a reason to believe that any hospital
has violated this section, the attorney general may bring an action against the hospital
to obtain temporary, preliminary, or permanent injunctive relief for any act, policy,
or practice by the hospital that violates this section. Before bringing such an action,
the attorney general may permit the hospital to submit a correction plan for the attorney
general's approval.