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HOUSE DOCKET, NO. 4008 FILED ON: 1/17/2025
HOUSE . . . . . . . . . . . . . . . No. 1386
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
John J. Mahoney
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act to ensure uniform and transparent reporting of medical debt data.
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PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:John J. Mahoney13th Worcester1/17/2025 1 of 5
HOUSE DOCKET, NO. 4008 FILED ON: 1/17/2025
HOUSE . . . . . . . . . . . . . . . No. 1386
By Representative Mahoney of Worcester, a petition (accompanied by bill, House, No. 1386) of
John J. Mahoney for legislation to establish an electronic system of public reporting for
providers as a prerequisite condition for advancing overdue medical bills to debt collection
agencies. Health Care Financing.
The Commonwealth of Massachusetts
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In the One Hundred and Ninety-Fourth General Court
(2025-2026)
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An Act to ensure uniform and transparent reporting of medical debt data.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Section 7 of chapter 6D of the General Laws, as so appearing in the 2022
2Official Edition, is hereby amended by striking subsection (d) in its entirety and inserting in
3place thereof the following:-
4 (d) The commission shall consider proposals that achieve 1 or more of the following
5goals: (i) to support safety-net provider and disproportionate share hospital participation in new
6payment and health care payment and service delivery models; (ii) to support the successful
7implementation of performance improvement plans by health care entities under subsection (c)
8of section 10; (iii) to support cooperative efforts between representatives of employees and
9management that are focused on controlling costs and improving the quality of care through
10workforce engagement; (iv) to support the evaluation of mobile health and connected health
11technologies to improve health outcomes among under-served patients with chronic diseases; (v)
12to develop the capacity to safely and effectively treat chronic, common, and complex diseases in 2 of 5
13rural and underserved areas and to monitor outcomes of those treatments; (vi) to reimburse the
14center for health information analysis on all funds expended for the purposes of executing the
15uniform medical debt reporting system established in section 25 of chapter 12C; and (vii) any
16other goals as determined by the commission.
17 SECTION 2. Section 1 of chapter 12C of the General Laws, as so appearing, is hereby
18amended by inserting after the definition of ''Medical assistance program'' the following
19definition:-
20 “Medical debt”, any debt owed for goods or services provided by a medical facility, a
21provider of health care or a provider of emergency medical services including the financing or an
22extension of credit by a third party for the sole purpose of purchasing goods or services provided
23by a medical facility, a provider of health care or a provider of emergency medical services.
24 And is further amended by inserting after the definition of ''Self-insured group'' the
25following definition:-
26 “Significant medical debt”, any medical debt owed by an individual exceeding $200.
27 SECTION 3. Said chapter 12C of the General Laws, as so appearing, is hereby further
28amended by inserting after section 24 the following new section:-
29 Section 25. Uniform medical debt reporting system
30 (a) The center shall coordinate with the public health council, the boards of registration
31for providers, the commission board, and the state finance and governance board to develop a
32uniform and interoperable electronic system of public reporting for providers as a prerequisite
33condition for advancing overdue medical bills to a debt collection agency. 3 of 5
34 (b) The uniform medical debt reporting system shall include information designed to
35advise on policy relating to medical debt. The uniform medical debt reporting system shall also
36ensure a comprehensive and transparent analysis of demographic data as it relates to medical
37debt including, but not limited to, rates of medical debt carried in the following demographics:
38(1) race; (2) sex, gender identity, and sexual orientation; (2) disability status; (3) criminal record;
39(4) health status; (5) family and individual income level; (6) education; (7) nation of origin; (8)
40region of residence in the commonwealth; (8) individual and family health insurance status; (8)
41veteran status; (9) age group; (10) chronic condition status; (11) education level; (12) primary
42language; and (13) times between procedures and reporting of debt to a collection agency.
43 (c) The purpose of the uniform medical debt reporting system is to reduce the adverse
44effects of medical debt and to protect patients in matters related to medical creditors, medical
45debt buyers, and medical debt collectors with respect to such debt. As such, the center shall
46collect and analyze data on all aspects related to the purposes of this section including, but not
47limited to: trends of medical debt assignment and collection per provider; rates of medical debt
48qualifying as “significant” as defined in section 1; the relative concentration of individual and
49family debt per person as compared to the total amount of medical debt in the commonwealth;
50any risks associated with masking medical debt data; the impact of medical debt data on public
51health and welfare; and dating relating to the rate at which those carrying medical debts
52successfully settle such debt.
53 (d) The center may centralize the uniform medical debt reporting system or create a
54central portal for public access to the medical debt data and information. The uniform medical
55debt reporting system shall be accessible to other state agencies and authorities including, but not 4 of 5
56limited to, the commission, the secretary for the executive office of health and human services,
57the department of public health, and the state finance and governance board.
58 (e) The center shall promptly make available to the secretary of the executive office of
59health and human services all data pursuant to subsection (a) prior to a provider sending such
60debt information to a collection agency.
61 (f) The center shall coordinate with the commission, through its oversight and control of
62the Healthcare Payment Reform Fund, pursuant to section 7 of chapter 6D, to receive
63reimbursement funds for the purposes of executing the uniform medical debt reporting system as
64established in this section.
65 SECTION 4. Section 52 of chapter 93 of the General Laws, as so appearing, is hereby
66amended by inserting after clause (6) of subsection (a) the following two clauses:-
67 (7) Information concerning medical debt arising from the receipt of health care services.
68 (8) Medical debt which has:
69 (a) not yet been reported to the secretary of the executive office of health and human
70services pursuant to section 25(c) of chapter 12C;
71 (b) already been fully paid or settled; or
72 (c) existed for less than one year from the date of first acquisition.
73 SECTION 5. Said section 52 of said chapter 93, as so appearing, is hereby further
74amended by striking subsection (b) and inserting in place thereof the following subsection:- 5 of 5
75 (b) Except for the provisions in clause (8), the provisions of subsection (a) are not
76applicable in the case of any consumer credit report to be used in connection with:
77 (1) a credit transaction involving, or which may reasonably be expected to involve, a
78principal amount of fifty thousand dollars or more; or
79 (2) the underwriting of life insurance involving, or which may reasonably be expected to
80involve, a face amount of fifty thousand dollars or more.