| 1 | 1 | | 25 LC 44 3135ER |
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| 2 | 2 | | House Bill 765 |
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| 3 | 3 | | By: Representatives Campbell of the 35 |
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| 4 | 4 | | th |
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| 5 | 5 | | , Roberts of the 52 |
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| 6 | 6 | | nd |
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| 7 | 7 | | , Cummings of the 39 |
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| 8 | 8 | | th |
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| 9 | 9 | | , Panitch |
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| 10 | 10 | | of the 51 |
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| 11 | 11 | | st |
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| 12 | 12 | | , Hugley of the 141 |
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| 13 | 13 | | st |
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| 14 | 14 | | , and others |
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| 15 | 15 | | A BILL TO BE ENTITLED |
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| 16 | 16 | | AN ACT |
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| 17 | 17 | | To amend Part 2 of Article 15 of Chapter 1 of Title 10 of the Official Code of Georgia |
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| 18 | 18 | | 1 |
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| 19 | 19 | | Annotated, the "Fair Business Practices Act of 1975," so as to provide for information on2 |
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| 20 | 20 | | medical assistance; to provide for interest, fees, and payment plans; to provide for billing and3 |
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| 21 | 21 | | collection rules; to provide for liability for medical debt; to provide for consumer reporting4 |
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| 22 | 22 | | agencies; to prohibit collection of medical debt during health insurance appeals; to provide5 |
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| 23 | 23 | | for accessibility; to provide for remedies; to provide for agreements; to provide for6 |
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| 24 | 24 | | definitions; to provide for a short title; to provide for related matters; to repeal conflicting7 |
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| 25 | 25 | | laws; and for other purposes.8 |
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| 26 | 26 | | BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:9 |
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| 27 | 27 | | SECTION 1.10 |
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| 28 | 28 | | This Act shall be known and may be cited as the "Medical Debt Protection Act."11 |
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| 29 | 29 | | SECTION 2.12 |
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| 30 | 30 | | Part 2 of Article 15 of Chapter 1 of Title 10 of the Official Code of Georgia Annotated, the13 |
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| 31 | 31 | | "Fair Business Practices Act of 1975," is amended by adding a new Code section to read as14 |
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| 32 | 32 | | follows:15 |
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| 33 | 33 | | H. B. 765 |
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| 34 | 34 | | - 1 - 25 LC 44 3135ER |
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| 35 | 35 | | "10-1-393.20.16 |
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| 36 | 36 | | (a) As used in this Code section, the term:17 |
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| 37 | 37 | | (1) 'Consumer' means an individual and excludes nonhuman entities.18 |
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| 38 | 38 | | (2) 'Consumer reporting agency' means any person, which, for monetary fees, dues, or19 |
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| 39 | 39 | | on a cooperative nonprofit basis, regularly engages in whole or in part in the practice of20 |
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| 40 | 40 | | assembling or evaluating consumer credit information or other information on consumers21 |
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| 41 | 41 | | for the purpose of furnishing consumer reports to third parties.22 |
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| 42 | 42 | | (3) 'External review' means a review of an adverse benefit determination, including a23 |
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| 43 | 43 | | final internal adverse benefit determination, conducted pursuant to any applicable state24 |
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| 44 | 44 | | external review process, a federal external review process as described at 42 U.S.C.25 |
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| 45 | 45 | | Section 300gg-19, a review pursuant to 29 U.S.C. Section 1133, a Medicare appeals26 |
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| 46 | 46 | | process, a Medicaid appeals process, or another applicable appeals process.27 |
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| 47 | 47 | | (4) 'Extraordinary collection action' means:28 |
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| 48 | 48 | | (A) Selling an individual's debt to another party, except if, prior to the sale, the medical29 |
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| 49 | 49 | | creditor has entered into a legally binding written agreement with the medical debt30 |
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| 50 | 50 | | buyer of the debt under which:31 |
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| 51 | 51 | | (i) The medical debt buyer or collector is prohibited from engaging in any32 |
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| 52 | 52 | | extraordinary collection actions to obtain payment for the care;33 |
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| 53 | 53 | | (ii) The medical debt buyer is prohibited from charging interest on the debt;34 |
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| 54 | 54 | | (iii) The debt is returnable or recallable by the medical creditor upon a determination35 |
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| 55 | 55 | | by the medical creditor or medical debt buyer that the individual is eligible for36 |
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| 56 | 56 | | financial assistance; and37 |
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| 57 | 57 | | (iv) The medical debt buyer shall adhere to procedures which shall be specified in the38 |
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| 58 | 58 | | agreement that ensure that the individual does not pay, and has no obligation to pay,39 |
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| 59 | 59 | | the medical debt buyer and the medical creditor together more than they are40 |
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| 60 | 60 | | personally responsible for paying in compliance with this Code section;41 |
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| 61 | 61 | | H. B. 765 |
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| 62 | 62 | | - 2 - 25 LC 44 3135ER |
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| 63 | 63 | | (B) Reporting adverse information about the consumer to a consumer reporting42 |
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| 64 | 64 | | agency; or43 |
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| 65 | 65 | | (C) Actions that require a legal or judicial process, including:44 |
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| 66 | 66 | | (i) Placing a lien on an individual's property;45 |
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| 67 | 67 | | (ii) Attaching or seizing an individual's bank account or any other personal property;46 |
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| 68 | 68 | | (iii) Commencing a civil action against an individual; or47 |
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| 69 | 69 | | (iv) Garnishing an individual's wages.48 |
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| 70 | 70 | | (5) 'Financial assistance policy' means a written policy made pursuant to 26 U.S.C.49 |
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| 71 | 71 | | Section 501(r)(4) or its implementing regulations, including 26 CFR Section 1.501(r)-1.50 |
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| 72 | 72 | | (6) 'Healthcare services' means services for the diagnosis, prevention, treatment, cure,51 |
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| 73 | 73 | | or relief of a physical, dental, behavioral, substance use disorder, or mental health52 |
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| 74 | 74 | | condition, illness, injury, or disease. Such term includes any procedures, products,53 |
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| 75 | 75 | | devices, or medications.54 |
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| 76 | 76 | | (7) 'Internal review' means review by a health insurance plan or other insurer of an55 |
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| 77 | 77 | | adverse benefit determination.56 |
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| 78 | 78 | | (8) 'Large healthcare facility' means any of the following entities:57 |
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| 79 | 79 | | (A) A licensed hospital, whether a not for profit entity or a for profit entity;58 |
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| 80 | 80 | | (B) A licensed nursing home, whether a not for profit entity or a for profit entity;59 |
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| 81 | 81 | | (C) An outpatient clinic or facility affiliated with a hospital or operating under the60 |
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| 82 | 82 | | license of a hospital;61 |
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| 83 | 83 | | (D) A licensed freestanding emergency department; and62 |
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| 84 | 84 | | (E) A licensed outpatient surgery center.63 |
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| 85 | 85 | | (9) 'Medical assistance' means any public assistance program that assists consumers with64 |
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| 86 | 86 | | healthcare costs.65 |
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| 87 | 87 | | (10) 'Medical creditor' means any large healthcare facility that provides healthcare66 |
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| 88 | 88 | | services and to whom the consumer owes money for healthcare services, or the large67 |
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| 89 | 89 | | healthcare facility that provided healthcare services and to whom the consumer owes68 |
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| 90 | 90 | | H. B. 765 |
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| 91 | 91 | | - 3 - 25 LC 44 3135ER |
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| 92 | 92 | | money for healthcare services, or the large healthcare facility that provided healthcare69 |
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| 93 | 93 | | services and to whom the consumer previously owed money if the medical debt has been70 |
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| 94 | 94 | | purchased by one or more medical debt buyers.71 |
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| 95 | 95 | | (11) 'Medical debt buyer' means an individual or entity that is engaged in the business72 |
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| 96 | 96 | | of purchasing medical debts for collection purposes, whether it collects the debt itself or73 |
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| 97 | 97 | | hires a third party for collection or an attorney for litigation in order to collect such debt.74 |
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| 98 | 98 | | (12) 'Medical debt collector' means any person that regularly collects or attempts to75 |
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| 99 | 99 | | collect, directly or indirectly, medical debts originally owed or due or asserted to be owed76 |
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| 100 | 100 | | or due to another. A medical debt buyer is a medical debt collector. Such term does not77 |
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| 101 | 101 | | include the Department of Human Services or an individual filing a child support action78 |
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| 102 | 102 | | under Title 19. Medical debt collector does not include anyone collecting debt charged79 |
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| 103 | 103 | | to a credit card.80 |
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| 104 | 104 | | (13) 'Patient' means the individual who received healthcare services or is discharged81 |
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| 105 | 105 | | from a large healthcare facility, or within ten days of discharge if the patient receives82 |
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| 106 | 106 | | emergency care.83 |
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| 107 | 107 | | (14) 'Time of service' means before a patient leaves or is discharged from a large84 |
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| 108 | 108 | | healthcare facility, or within ten days of discharge if the patient receives emergency care.85 |
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| 109 | 109 | | (b)(1) All large healthcare facilities shall provide uninsured patients with a written notice86 |
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| 110 | 110 | | containing information regarding eligibility and the application process for medical87 |
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| 111 | 111 | | assistance at the time of service.88 |
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| 112 | 112 | | (2) Each billing statement that a large healthcare facility sends to an uninsured patient89 |
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| 113 | 113 | | shall include a written notice containing information regarding medical assistance and the90 |
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| 114 | 114 | | application process for medical assistance.91 |
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| 115 | 115 | | (3) The written notice required by paragraphs (1) and (2) of this subsection shall include:92 |
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| 116 | 116 | | (A) A statement that the consumer may qualify for medical assistance;93 |
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| 117 | 117 | | H. B. 765 |
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| 118 | 118 | | - 4 - 25 LC 44 3135ER |
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| 119 | 119 | | (B) A statement describing how consumers may apply for medical assistance,94 |
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| 120 | 120 | | including a website and telephone number where information on applying for such95 |
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| 121 | 121 | | assistance may be obtained;96 |
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| 122 | 122 | | (C) A list of local organizations or public or private agencies that may provide97 |
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| 123 | 123 | | assistance with an application for medical assistance; and98 |
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| 124 | 124 | | (D) A contact number for the consumer to call a large healthcare facility to reach99 |
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| 125 | 125 | | someone who can assist the consumer with an application for medical assistance.100 |
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| 126 | 126 | | (4) The notice required under this subsection shall only be sent to patients who received101 |
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| 127 | 127 | | services in an emergency department, admitted to a hospital, or receiving surgery in a102 |
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| 128 | 128 | | large healthcare facility.103 |
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| 129 | 129 | | (c)(1) Large healthcare facilities and medical debt collectors may not charge any interest104 |
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| 130 | 130 | | or late fees to consumers.105 |
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| 131 | 131 | | (2) Large healthcare facilities and medical debt collectors shall offer to any consumer106 |
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| 132 | 132 | | with outstanding debt totaling $500.00 or more a payment plan and may not require the107 |
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| 133 | 133 | | consumer to make monthly payments that exceed 5 percent of the consumer's gross108 |
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| 134 | 134 | | monthly income. Failure to provide proof of income may not be used as a basis to deny109 |
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| 135 | 135 | | any consumer a payment plan.110 |
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| 136 | 136 | | (3) No initial payment on a monthly payment plan may be due under any of the111 |
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| 137 | 137 | | following circumstances:112 |
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| 138 | 138 | | (A) Within the first 30 days after the healthcare services were provided;113 |
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| 139 | 139 | | (B) Within 30 days after the first bill is sent; or114 |
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| 140 | 140 | | (C) During any period in which a medical creditor or medical debt collector has115 |
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| 141 | 141 | | requested any form of documentation from a consumer.116 |
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| 142 | 142 | | (4) Prepayment or early payment penalties or fees, service or administrative charges or117 |
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| 143 | 143 | | fees, or any other fees or charges unrelated to the care provided shall be prohibited,118 |
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| 144 | 144 | | including on any prepayment plans.119 |
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| 145 | 145 | | H. B. 765 |
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| 146 | 146 | | - 5 - 25 LC 44 3135ER |
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| 147 | 147 | | (5) Notwithstanding any other provisions in this Code section, a consumer shall not be120 |
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| 148 | 148 | | prohibited from voluntarily making any additional or early payments on any medical debt121 |
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| 149 | 149 | | at any time.122 |
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| 150 | 150 | | (d)(1) The following extraordinary collections actions may not be used by any medical123 |
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| 151 | 151 | | creditor or debt collector to collect debts owed for healthcare services:124 |
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| 152 | 152 | | (A) Causing an individual's arrest;125 |
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| 153 | 153 | | (B) Causing an individual to be subject to a writ of body attachment or capias;126 |
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| 154 | 154 | | (C) Foreclosing on an individual's real property;127 |
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| 155 | 155 | | (D) Garnishing the wages, disability insurance payments or any other disability128 |
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| 156 | 156 | | benefits, workers' compensation payments or unemployment benefits of a consumer;129 |
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| 157 | 157 | | or130 |
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| 158 | 158 | | (E) Garnishing or attaching a bank account, pension, annuity, or retirement account of131 |
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| 159 | 159 | | a consumer.132 |
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| 160 | 160 | | (2) A large healthcare facility or medical creditor that sells medical debt to a medical133 |
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| 161 | 161 | | debt buyer or medical debt collector under a contract remains liable for any actions taken134 |
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| 162 | 162 | | by the medical debt buyer or medical debt collector, including any violations of any135 |
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| 163 | 163 | | provisions of this Code section.136 |
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| 164 | 164 | | (3) No medical creditor or medical debt collector may engage in any permissible137 |
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| 165 | 165 | | extraordinary collection actions until 120 days after the first bill for a medical debt has138 |
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| 166 | 166 | | been sent.139 |
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| 167 | 167 | | (4) At least 30 days before taking any extraordinary collection actions, a medical creditor140 |
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| 168 | 168 | | or medical debt collector shall provide to the consumer a notice containing:141 |
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| 169 | 169 | | (A) In the case of large healthcare facilities and medical debt collectors collecting debt142 |
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| 170 | 170 | | for healthcare services provided by such facilities, stating whether financial assistance143 |
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| 171 | 171 | | is available for eligible individuals and providing a plain-language summary of any144 |
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| 172 | 172 | | such financial assistance policy;145 |
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| 173 | 173 | | H. B. 765 |
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| 174 | 174 | | - 6 - 25 LC 44 3135ER |
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| 175 | 175 | | (B) Identifying the extraordinary collection actions that will be initiated in order to146 |
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| 176 | 176 | | obtain payment; and147 |
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| 177 | 177 | | (C) Providing a deadline after which such extraordinary collection actions shall be148 |
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| 178 | 178 | | initiated; provided, however, that such date may be no earlier than 30 days after the date149 |
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| 179 | 179 | | of the notice.150 |
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| 180 | 180 | | (5) A large healthcare facility or a medical debt collector collecting the debt for151 |
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| 181 | 181 | | healthcare services provided by such a facility may not use any extraordinary collection152 |
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| 182 | 182 | | actions unless such actions are described in the large healthcare facility's billing and153 |
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| 183 | 183 | | collections policy.154 |
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| 184 | 184 | | (6) If the consumer has paid any part of the medical debt in excess of the amount the155 |
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| 185 | 185 | | consumer owes after any financial assistance or charity care offered by the large156 |
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| 186 | 186 | | healthcare facility, the large healthcare facility or medical debt collector shall refund any157 |
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| 187 | 187 | | excess amount to the consumer within 60 days. If a change in the financial circumstances158 |
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| 188 | 188 | | of the consumer makes the consumer eligible for any financial assistance or charity care,159 |
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| 189 | 189 | | any payments made prior to the change in circumstances that make the patient eligible160 |
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| 190 | 190 | | for such financial assistance or charity care shall not be required to be refunded.161 |
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| 191 | 191 | | (7) A large healthcare facility or medical creditor that sells medical debt to a medical162 |
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| 192 | 192 | | debt buyer or medical debt collector under a contract remains liable for any actions taken163 |
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| 193 | 193 | | by the medical debt buyer or medical debt collector, including any violations of any164 |
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| 194 | 194 | | provisions of this Code section.165 |
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| 195 | 195 | | (e)(1) Parents shall be jointly liable for any medical debts incurred by children under the166 |
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| 196 | 196 | | age of 18.167 |
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| 197 | 197 | | (2) No spouse or other person may be liable for the medical debt or nursing home debt168 |
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| 198 | 198 | | of any other person age 18 or older. A spouse may voluntarily consent to assume169 |
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| 199 | 199 | | liability, but such consent:170 |
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| 200 | 200 | | (A) Shall be on a separate stand-alone document signed by the spouse;171 |
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| 201 | 201 | | (B) May not be solicited in an emergency room or during an emergency situation; and172 |
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| 202 | 202 | | H. B. 765 |
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| 203 | 203 | | - 7 - 25 LC 44 3135ER |
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| 204 | 204 | | (C) May not be required as a condition of providing any emergency or nonemergency173 |
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| 205 | 205 | | healthcare services.174 |
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| 206 | 206 | | (f)(1) For a period of one year following the date when the consumer was first given a175 |
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| 207 | 207 | | bill for medical debt or three months following the date of the most recent payment made176 |
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| 208 | 208 | | toward a payment plan on medical debt, whichever is later, no medical creditor or177 |
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| 209 | 209 | | medical debt collector may communicate with or report any information to any consumer178 |
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| 210 | 210 | | reporting agency regarding such medical debt.179 |
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| 211 | 211 | | (2) After the time period described in paragraph (1) of this subsection, medical creditors180 |
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| 212 | 212 | | and medical debt collectors shall give consumers at least one additional bill before181 |
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| 213 | 213 | | reporting a medical debt to any consumer reporting agency. The amount reported to the182 |
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| 214 | 214 | | consumer reporting agency shall be the same amount stated in this bill, and such bill shall183 |
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| 215 | 215 | | state that the debt is being reported to a consumer reporting agency. Medical debt184 |
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| 216 | 216 | | collectors shall also provide the notice required by 15 U.S.C. Section 1692g before185 |
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| 217 | 217 | | reporting a debt to a consumer reporting agency.186 |
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| 218 | 218 | | (g)(1) No medical creditor or medical debt collector that knows or should know about187 |
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| 219 | 219 | | an internal review, external review, or other appeal of a health insurance decision that is188 |
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| 220 | 220 | | pending or was pending within the previous 60 days may do any of the following:189 |
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| 221 | 221 | | (A) Provide information relative to unpaid charges for healthcare services to a190 |
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| 222 | 222 | | consumer reporting agency;191 |
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| 223 | 223 | | (B) Communicate with the consumer regarding the unpaid charges for healthcare192 |
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| 224 | 224 | | services for the purpose of seeking to collect the charges; or193 |
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| 225 | 225 | | (C) Initiate a lawsuit or arbitration proceeding against the consumer relative to unpaid194 |
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| 226 | 226 | | charges for healthcare services.195 |
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| 227 | 227 | | (2) If a medical debt has previously been reported to a consumer reporting agency and196 |
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| 228 | 228 | | the medical creditor or medical debt collector that reported the information learns of an197 |
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| 229 | 229 | | internal review, external review, or other appeal of a health insurance decision that is198 |
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| 230 | 230 | | pending or was pending within the previous 60 days, such medical creditor or medical199 |
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| 231 | 231 | | H. B. 765 |
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| 232 | 232 | | - 8 - 25 LC 44 3135ER |
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| 233 | 233 | | debt collector shall instruct the consumer reporting agency to delete the information about200 |
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| 234 | 234 | | the debt.201 |
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| 235 | 235 | | (3) No medical creditor that knows or should have known about an internal review,202 |
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| 236 | 236 | | external review, or other appeal of a health insurance decision that is pending or was203 |
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| 237 | 237 | | pending within the previous 60 days may refer, place, or send the unpaid charges for204 |
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| 238 | 238 | | healthcare services to a medical debt collector including by selling the debt to a medical205 |
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| 239 | 239 | | debt buyer.206 |
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| 240 | 240 | | (h)(1) Consumers may not be charged interest or late fees on medical debt, regardless of207 |
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| 241 | 241 | | any agreements to the contrary.208 |
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| 242 | 242 | | (2) Paragraph (1) of this subsection shall apply to any judgments resulting from medical209 |
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| 243 | 243 | | debt, regardless of any agreements to the contrary.210 |
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| 244 | 244 | | (i) A large healthcare facility shall provide a contact number with which a consumer may211 |
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| 245 | 245 | | request oral interpretation services, at no cost to the consumer, for any information or212 |
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| 246 | 246 | | document that is provided to the consumer under this Code section.213 |
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| 247 | 247 | | (j)(1) In addition to any remedies a consumer may have at law or in equity, any violation214 |
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| 248 | 248 | | of this Code section is an unlawful practice under this part.215 |
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| 249 | 249 | | (2) Any consumer may sue for injunctive or other appropriate equitable relief to enforce216 |
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| 250 | 250 | | this Code section.217 |
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| 251 | 251 | | (3) The remedies provided in this subsection are not intended to be the exclusive218 |
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| 252 | 252 | | remedies available to a consumer nor shall the consumer exhaust any administrative219 |
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| 253 | 253 | | remedies provided under this subsection or any other applicable law.220 |
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| 254 | 254 | | (4) No agreement between the consumer and a large healthcare provider or medical debt221 |
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| 255 | 255 | | collector may contain a provision that, prior to a dispute arising, waives or inhibits or has222 |
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| 256 | 256 | | the practical effect of waiving or inhibiting any rights under this Code section or the223 |
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| 257 | 257 | | rights of a consumer to resolve that dispute by obtaining any of the following:224 |
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| 258 | 258 | | (A) Injunctive, declaratory, or other equitable relief;225 |
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| 259 | 259 | | (B) Multiple or minimum damages as specified by statute;226 |
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| 260 | 260 | | H. B. 765 |
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| 261 | 261 | | - 9 - 25 LC 44 3135ER |
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| 262 | 262 | | (C) Attorney's fees and costs as specified by statute or as available at common law;227 |
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| 263 | 263 | | (D) A hearing at which that party can present evidence; or228 |
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| 264 | 264 | | (E) Requiring any form of alternative dispute resolution, including arbitration.229 |
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| 265 | 265 | | (5) Any provision in a written agreement violating any provision of this Code section230 |
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| 266 | 266 | | shall be void and unenforceable. A court may refuse to enforce any written agreement231 |
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| 267 | 267 | | as equity may require.232 |
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| 268 | 268 | | SECTION 3.233 |
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| 269 | 269 | | All laws and parts of laws in conflict with this Act are repealed.234 |
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| 270 | 270 | | H. B. 765 |
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| 271 | 271 | | - 10 - |
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