[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8311 Introduced in House (IH)]
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118th CONGRESS
2d Session
H. R. 8311
To cancel existing medical debt, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 8, 2024
Mr. Khanna (for himself, Ms. Tlaib, Mr. Bowman, Mr. Casar, Ms. Jayapal,
Ms. Lee of Pennsylvania, Mr. McGovern, Ms. Omar, Ms. Pressley, Mrs.
Ramirez, Ms. Schakowsky, Mr. Takano, and Ms. Velazquez) introduced the
following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committee on Financial Services, for a
period to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
_______________________________________________________________________
A BILL
To cancel existing medical debt, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Medical Debt Cancellation Act''.
SEC. 2. GRANTS TO CANCEL MEDICAL DEBT OWED BY PATIENTS.
Section 2799B-10 of the Public Health Service Act, as added by
section 3, is amended by adding at the end the following:
``(e) Grants To Cancel Medical Debt Owed by Patients.--
``(1) In general.--The Secretary shall establish a grant
program under which the Secretary, beginning not later than 1
year after the date of enactment of the Medical Debt
Cancellation Act, awards grants on a competitive basis to
hospitals in the United States in order to eliminate all
eligible medical debt owed by residents of the United States to
such hospitals.
``(2) Eligibility.--To be eligible to receive a grant under
this subsection, a hospital shall--
``(A) submit an application to the Secretary at
such time, in such manner, and containing such
information as the Secretary may require; and
``(B) agree to submit to the Secretary such reports
regarding the use of grant funds as the Secretary may
require.
``(3) Prioritization.--In awarding grants under this
subsection, the Secretary shall--
``(A) prioritize awards to hospitals that--
``(i) are safety net hospitals; and
``(ii) agree to cancel, at a minimum, all
medical debt that is--
``(I) 15 months old or less;
``(II) owed by low-income and
vulnerable patient populations; and
``(III) attributable to emergency
and non-elective care; and
``(B) ensure that awards are distributed to
hospitals across diverse geographical areas of the
United States.
``(4) Supplement, not supplant.--Grants awarded to a
hospital under this subsection shall be used to supplement, and
not supplant, other sources of funding and investments made by
the hospital for the purposes of providing financial assistance
to patients.
``(5) Expansion of medical debt cancellation.--Not later
than 2 years after the date of enactment of the Medical Debt
Cancellation Act, the Secretary shall expand the program under
this subsection to allow providers and health care facilities
other than hospitals, and individuals, to receive medical debt
cancellation.
``(6) Guidance.--Not later than 1 year after the date of
enactment of the Medical Debt Cancellation Act, the Secretary
shall instruct Federal health care programs to eliminate
medical debt collections.
``(7) Consultation.--In carrying out this subsection, the
Secretary shall consult with relevant Federal agencies,
departments, and health programs, patient advocates, community-
based organizations with experience in medical debt
cancellation, providers, and other key stakeholders.
``(8) Reporting.--Beginning 2 years after the date of
enactment of the Medical Debt Cancellation Act, and annually
thereafter until the date on which the program under this
subsection sunsets pursuant to paragraph (10), the Secretary
shall submit to relevant congressional committees a progress
report on the implementation, administration, and impact of the
program under this subsection.
``(9) Definitions.--In this subsection--
``(A) the term `eligible medical debt'--
``(i) means the out-of-pocket unpaid amount
owed by a resident of the United States for
items or services furnished to such individual
by a hospital, provided that--
``(I) such medical debt is in
compliance with applicable Federal laws
and regulations, including--
``(aa) the medical billing
requirements of subsection (a);
``(bb) the medical debt
collection requirements of
subsection (b); and
``(cc) the contracting
limitation under subsection
(c);
``(II) such medical debt is with
respect to items and services furnished
to an individual on or before the date
of enactment of the Medical Debt
Cancellation Act; and
``(III) any dispute resolution
process under section 2799B-7 is
complete; and
``(ii) excludes--
``(I) any amount paid or payable by
any Federal health care program; and
``(II) with respect to items and
services furnished to an individual by
the hospital, any amount that is in
excess of the sum of the amount
reimbursable by a Federal health care
program or other payer and copayment
amounts under such a program or other
health insurance plan with respect to
such items and services.
``(B) the term `Federal health care program' has
the meaning given such term in section 1128B(f) of the
Social Security Act.
``(10) Sunset.--The authorities under this subsection shall
sunset on the date the Secretary certifies all eligible medical
debt in the United States has been canceled under this
subsection.''.
SEC. 3. REQUIREMENTS FOR MEDICAL BILLING PRACTICES AND MEDICAL DEBT
COLLECTION; MEDICAL PAYMENT ASSISTANCE.
(a) In General.--Part E of title XXVII of the Public Health Service
Act (42 U.S.C. 300gg-131 et seq.) is amended by adding at the end the
following new section:
``SEC. 2799B-10. REQUIREMENTS FOR MEDICAL BILLING AND MEDICAL DEBT
COLLECTION; MEDICAL PAYMENT ASSISTANCE RESOURCE.
``(a) Medical Billing Requirements.--In the case of a health care
provider or facility that furnishes items or services to an individual,
such provider or facility shall, not later than 45 days before the date
on which payment for such items or services is due--
``(1)(A) determine whether such individual is eligible for
assistance with respect to such payment pursuant to the charity
care or financial assistance policy of such provider or
facility; and
``(B) if such individual is eligible for such assistance,
provide information to such individual regarding such
assistance; and
``(2) on or after the date on which the medical payment
assistance resource list under subsection (d)(1) is made
available, provide such individual with such list.
``(b) Medical Debt Collection Requirements.--
``(1) In general.--In the case of a health care provider or
facility that furnishes items or services to an individual, if
payment for such items or services is past due, such provider
or facility shall--
``(A) not later than 30 days after the date on
which the payment was due, provide to such individual a
statement (in clear and understandable language) that
includes--
``(i) subject to paragraph (2)(A), the
total amount of the payment that remains due;
``(ii) a description of the attempts made
by such provider or facility to determine
whether such individual is eligible for
assistance (as described in subsection (a)(1))
with respect to the payment; and
``(iii) in each of the 15 most commonly
used languages (other than English), as
determined by the Secretary, information about
language-assistance services related to the
payment that are available to individuals with
limited English proficiency; and
``(B) not later than 30 days after a payment
related to such items or services is made, provide to
such individual a detailed receipt of such payment and
a statement of the amount that remains due, if
applicable.
``(2) Limitations on medical debt amounts.--
``(A) Uninsured individuals.--In the case of items
or services furnished to an uninsured individual by an
organization that is described in section 501(r)(2) of
the Internal Revenue Code of 1986 and is exempt from
taxation under section 501(c)(3) of such Code, such
organization may not collect payment from such
individual with respect to such items or services in an
amount greater than the amounts generally billed
(within the meaning of section 501(r) of such Code).
``(B) Interest rate.--A health care provider or
facility may not collect interest on past-due payments
for items or services furnished to an individual.
``(c) Limitation on Contracting for Purposes of Medical Billing and
Medical Debt Collection.--A health care provider or facility may not
enter into a contract with an entity for purposes of collecting payment
with respect to items or services furnished by such provider or
facility unless such entity agrees to comply with the requirements
described in subsections (a) and (b) for such provider or facility with
respect to such payment.
``(d) Medical Payment Assistance Resource List.--
``(1) In general.--Not later than 1 year after the date of
the enactment of the Medical Debt Cancellation Act, the
Secretary shall make publicly available on the website of the
Department of Health and Human Services a comprehensive list of
Federal, State, and local programs that provide financial
assistance with respect to payment for items or services
furnished by a health care provider or facility.
``(2) Updates.--The Secretary shall update the list
described in paragraph (1) not less frequently than
annually.''.
(b) Effective Date.--The amendments made by subsection (a) shall
apply with respect to items and services furnished on or after the date
that is 1 year after the date of the enactment of this Act.
(c) Coordination and Consultation.--In carrying out this section,
the Secretary of Health and Human Services shall--
(1) coordinate with relevant Federal departments and
agencies, including the Consumer Financial Protection Bureau
and the Department of the Treasury; and
(2) consult with relevant stakeholders including patient
advocates, community-based organizations with experience in
medical debt cancellation, and health care providers.
SEC. 4. MEDICAL DEBT COLLECTION.
(a) Collection of Medical Debt.--
(1) In general.--The Fair Debt Collection Practices Act (15
U.S.C. 1692 et seq.) is amended by inserting after section 818
(15 U.S.C. 1692p) the following:
``Sec. 818A. Collection of medical debt
``(a) In General.--No debt collector or creditor may collect or
attempt to collect debt that arose from the receipt of medical
services, products, or devices if such debt was incurred by a consumer
before the date of enactment of this section.
``(b) Private Right of Action.--Any consumer who is harmed by a
violation of subsection (a) may bring a civil action in the appropriate
United States district court against the debt collector or creditor
that violated subsection (a) for--
``(1) compensatory damages, including for economic losses
and for emotional harm;
``(2) punitive damages; and
``(3) reasonable attorney's fees and costs of the action to
a prevailing plaintiff.''.
(b) Technical and Conforming Amendment.--The table of sections for
the Fair Debt Collection Practices Act (15 U.S.C. 1692 et seq.) is
amended by inserting after the item relating to section 818 the
following:
``818A. Collection of medical debt.''.
SEC. 5. MEDICAL DEBT REPORTING.
(a) In General.--Section 605(a) of the Fair Credit Reporting Act
(15 U.S.C. 1681c(a)) is amended by adding at the end the following:
``(9) Any information related to debt that arose from the
receipt of medical services, products, or devices accrued by a
consumer.''.
(b) Notice Requirements.--Each credit reporting agency that removes
information from the consumer report of a consumer to comply with
section 605(a)(9) of the Fair Credit Reporting Act, as added by
subsection (a) of this section, shall notify the consumer of the
removal.
(c) Effective Date.--The amendment made by this section shall take
effect on the date that is 30 days after the date of enactment of this
section.
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