Vote Smart's Synopsis:

Vote to pass a bill that requires hospitals and their affiliates to provide financial assistance programs for medical care in Maine.

Highlights:

• Repeals and eliminates the existing law that requires the Department of Health and Human Services to adopt guidelines governing charity care and replaces it with a more comprehensive law governing charity care and other financial assistance programs provided by hospitals to patients to cover charges for services provided by that hospital (Sec. 1-6).

• Requires that hospitals provide charity care or free health care services to patients who are state residents and whose family income is equal to or less than 200% of the federal poverty level (Sec. 1-6).

• Establishes requirements concerning hospital-provided financial assistance programs and specific requirements applying only to charity care that hospitals must follow under rules adopted by the department concerning the application process, language interpretation, eligibility determinations, notification of eligibility determinations, and, in the case of charity care, rights to a hearing following a denial (Sec. 1-6).

• Requires that hospitals widely publicize their financial assistance programs within the community served by the hospital, including by (Sec. 1-6):

• Publishing a summary of the programs written in plain language;

• Providing physical copies of the summary, application, and application instructions in conspicuous locations within the hospital; and

• Posting a full, accessible, and downloadable version of the application on the hospital's publicly accessible website.

• Requires that a hospital provide individual written notice of the availability of charity care to each patient (Sec. 1-6).

• Specifies that for inpatient services, the notice must be provided upon admission, or in the case of emergency admission, before discharge. For outpatient services, individual notice must be included with the patient's bill or at the time service is provided (Sec. 1-6).

• Requires that a hospital notify a patient who is determined to be eligible for financial assistance if any part of the services provided are not covered by the hospital's financial assistance program. (Sec. 1-6).

• Specifies that a hospital that fails to provide this notice is prohibited from charging the patient for those services, but is permitted to charge the patient's health insurance carrier for those services (Sec. 1-6).

• Requires that a hospital must offer, for patients with family incomes that do not exceed 400% of the federal poverty level, a payment plan that requires monthly out-of-pocket payments that do not exceed 3% of the patient's monthly family income that is not exempt from attachment or garnishment under Maine law (Sec. 1-6).

• Requires hospitals to include on a patient's bill information concerning the process for disputing charges (Sec. 1-6).

• Requires that hospitals provide an online option for applying for charity care (Sec. 1-6).

• Requires the department to enforce the provisions of this bill. The department must

• Establishes a process to receive patient complaints for hospital noncompliance, conduct reviews of those complaints, and require corrective action when a hospital is found to be noncompliant (Sec. 1-6).

• Establishes a civil penalty not to exceed $1,000 for hospitals that knowingly or willfully violate the provisions of this bill or engage in a pattern of noncompliance with these provisions (Sec. 1-6).

• Requires the department to adopt rules by June 30, 2026, to carry out the purposes of this bill (Sec. 1-6).

• Specifies that the provisions of this bill shall take effect beginning January 1, 2026 (Sec. 7).

Full Bill Text

Vote Smart's Synopsis:

Vote to pass a bill that requires hospitals and their affiliates to provide financial assistance programs for medical care in Maine.

Highlights:

• Repeals and eliminates the existing law that requires the Department of Health and Human Services to adopt guidelines governing charity care and replaces it with a more comprehensive law governing charity care and other financial assistance programs provided by hospitals to patients to cover charges for services provided by that hospital (Sec. 1-6).

• Requires that hospitals provide charity care or free health care services to patients who are state residents and whose family income is equal to or less than 200% of the federal poverty level (Sec. 1-6).

• Establishes requirements concerning hospital-provided financial assistance programs and specific requirements applying only to charity care that hospitals must follow under rules adopted by the department concerning the application process, language interpretation, eligibility determinations, notification of eligibility determinations, and, in the case of charity care, rights to a hearing following a denial (Sec. 1-6).

• Requires that hospitals widely publicize their financial assistance programs within the community served by the hospital, including by (Sec. 1-6):

• Publishing a summary of the programs written in plain language;

• Providing physical copies of the summary, application, and application instructions in conspicuous locations within the hospital; and

• Posting a full, accessible, and downloadable version of the application on the hospital's publicly accessible website.

• Requires that a hospital provide individual written notice of the availability of charity care to each patient (Sec. 1-6).

• Specifies that for inpatient services, the notice must be provided upon admission, or in the case of emergency admission, before discharge. For outpatient services, individual notice must be included with the patient's bill or at the time service is provided (Sec. 1-6).

• Requires that a hospital notify a patient who is determined to be eligible for financial assistance if any part of the services provided are not covered by the hospital's financial assistance program. (Sec. 1-6).

• Specifies that a hospital that fails to provide this notice is prohibited from charging the patient for those services, but is permitted to charge the patient's health insurance carrier for those services (Sec. 1-6).

• Requires that a hospital must offer, for patients with family incomes that do not exceed 400% of the federal poverty level, a payment plan that requires monthly out-of-pocket payments that do not exceed 3% of the patient's monthly family income that is not exempt from attachment or garnishment under Maine law (Sec. 1-6).

• Requires hospitals to include on a patient's bill information concerning the process for disputing charges (Sec. 1-6).

• Requires that hospitals provide an online option for applying for charity care (Sec. 1-6).

• Requires the department to enforce the provisions of this bill. The department must

• Establishes a process to receive patient complaints for hospital noncompliance, conduct reviews of those complaints, and require corrective action when a hospital is found to be noncompliant (Sec. 1-6).

• Establishes a civil penalty not to exceed $1,000 for hospitals that knowingly or willfully violate the provisions of this bill or engage in a pattern of noncompliance with these provisions (Sec. 1-6).

• Requires the department to adopt rules by June 30, 2026, to carry out the purposes of this bill (Sec. 1-6).

• Specifies that the provisions of this bill shall take effect beginning January 1, 2026 (Sec. 7).

Full Bill Text