| 1 | 1 | | <STYLE><!--U {color: Green}S {color: RED} I {color: DARKBLUE; background-color:yellow} P.brk {page-break-before:always}--></STYLE> <BASEFONT SIZE=3> <PRE WIDTH="99"> <FONT SIZE=5><B> STATE OF NEW YORK</B></FONT> ________________________________________________________________________ 7479 2025-2026 Regular Sessions <FONT SIZE=5><B> IN SENATE</B></FONT> April 17, 2025 ___________ Introduced by Sen. HOYLMAN-SIGAL -- read twice and ordered printed, and when printed to be committed to the Committee on Judiciary AN ACT to amend the civil practice law and rules, the general business law and the public health law, in relation to medical debt <B><U>The People of the State of New York, represented in Senate and Assem-</U></B> <B><U>bly, do enact as follows:</U></B> 1 Section 1. Subdivision (a) of section 5201 of the civil practice law 2 and rules is amended to read as follows: 3 (a) Debt against which a money judgment may be enforced. A money judg- 4 ment may be enforced against any debt, which is past due or which is yet 5 to become due, certainly or upon demand of the judgment debtor, whether 6 it was incurred within or without the state, to or from a resident or 7 non-resident, unless it is exempt from application to the satisfaction 8 of the judgment. A debt may consist of a cause of action which could be 9 assigned or transferred accruing within or without the state. <B><U>No money</U></B> 10 <B><U>judgment shall be sought, entered, or enforced in an action arising from</U></B> 11 <B><U>non-payment of facility items and services by a patient or patient guar-</U></B> 12 <B><U>antor that is brought by a facility, as defined under section twenty-</U></B> 13 <B><U>eight hundred thirty-two of the public health law, that is in material</U></B> 14 <B><U>noncompliance with section twenty-eight hundred thirty-two of the public</U></B> 15 <B><U>health law on the date that the relevant facility items or services are</U></B> 16 <B><U>purchased from a provider to a patient by the facility in material</U></B> 17 <B><U>noncompliance.</U></B> 18 § 2. Section 7501 of the civil practice law and rules, as amended by 19 chapter 532 of the laws of 1963, is amended to read as follows: 20 § 7501. Effect of arbitration agreement. A written agreement to submit 21 any controversy thereafter arising or any existing controversy to arbi- 22 tration is enforceable without regard to the justiciable character of 23 the controversy and confers jurisdiction on the courts of the state to 24 enforce it and to enter judgment on an award. In determining any matter 25 arising under this article, the court shall not consider whether the EXPLANATION--Matter in <B><U>italics</U></B> (underscored) is new; matter in brackets [<B><S> </S></B>] is old law to be omitted. LBD08384-01-5 </PRE><P CLASS="brk"><PRE WIDTH="99"> S. 7479 2 1 claim with respect to which arbitration is sought is tenable, or other- 2 wise pass upon the merits of the dispute. <B><U>No facility, as defined under</U></B> 3 <B><U>section twenty-eight hundred thirty-two of the public health law, shall</U></B> 4 <B><U>enforce an arbitration agreement or clause in any facility document,</U></B> 5 <B><U>including contracts, agreements, statements, or bills, in an action</U></B> 6 <B><U>arising from patient or patient guarantor non-payment of facility items</U></B> 7 <B><U>or services, if that facility is in material noncompliance with section</U></B> 8 <B><U>twenty-eight hundred thirty-two of the public health law on the date</U></B> 9 <B><U>that the relevant facility items or services are purchased from a</U></B> 10 <B><U>provider to a patient by the facility in material noncompliance.</U></B> 11 § 3. Section 601 of the general business law is amended by adding two 12 new subdivisions 13 and 14 to read as follows: 13 <B><U>13. Attempt to collect a medical debt, or debt arising from nonpayment</U></B> 14 <B><U>of facility items and services, from a patient or patient guarantor by</U></B> 15 <B><U>referring the debt, directly or indirectly, to a debt collector or debt</U></B> 16 <B><U>collection agency if the principal creditor is a facility, as defined by</U></B> 17 <B><U>section twenty-eight hundred thirty-two of the public health law, or an</U></B> 18 <B><U>affiliate, that is in material noncompliance with section twenty-eight</U></B> 19 <B><U>hundred thirty-two of the public health law on the date that the rele-</U></B> 20 <B><U>vant facility items or services are purchased from a provider to a</U></B> 21 <B><U>patient by the facility; or</U></B> 22 <B><U>14. Disclose or cause to be disclosed information affecting the</U></B> 23 <B><U>debtor's reputation for credit worthiness, including to a consumer cred-</U></B> 24 <B><U>it reporting agency as defined in article twenty-five of this chapter,</U></B> 25 <B><U>if the principal creditor is a facility, as defined by section twenty-</U></B> 26 <B><U>eight hundred thirty-two of the public health law, or an affiliate, that</U></B> 27 <B><U>is in material noncompliance with section twenty-eight hundred thirty-</U></B> 28 <B><U>one of the public health law on the date that the relevant facility</U></B> 29 <B><U>items or services are purchased from a provider to a patient by the</U></B> 30 <B><U>facility, and the action arose from patient or patient guarantor non-</U></B> 31 <B><U>payment of facility items or services.</U></B> 32 § 4. The public health law is amended by adding a new section 2832 to 33 read as follows: 34 <B><U>§ 2832. The hospital price transparency act. 1. As used in this</U></B> 35 <B><U>section:</U></B> 36 <B><U>(a) "Ancillary service" means a facility item or service that a facil-</U></B> 37 <B><U>ity customarily provides as part of or in conjunction with a shoppable</U></B> 38 <B><U>primary service.</U></B> 39 <B><U>(b) "Chargemaster" means the list of all facility items and services</U></B> 40 <B><U>maintained by a facility for which the facility has established a</U></B> 41 <B><U>charge.</U></B> 42 <B><U>(c) "Collections action" includes any of the following actions taken</U></B> 43 <B><U>with respect to a debt for items and services that were purchased from</U></B> 44 <B><U>or provided to a patient by a facility:</U></B> 45 <B><U>(i) attempting to collect a debt from a patient or patient guarantor</U></B> 46 <B><U>by referring the debt, directly or indirectly, to a debt collector, a</U></B> 47 <B><U>collection agency, or other third-party retained by or on behalf of the</U></B> 48 <B><U>facility;</U></B> 49 <B><U>(ii) initiating a lawsuit against the patient or patient guarantor, or</U></B> 50 <B><U>enforcing an arbitration or mediation clause in any facility documents</U></B> 51 <B><U>including contracts, agreements, statements, or bills; or</U></B> 52 <B><U>(iii) directly or indirectly causing a report to be made to a consumer</U></B> 53 <B><U>reporting agency.</U></B> 54 <B><U>(d) "De-identified maximum negotiated charge" means the highest charge</U></B> 55 <B><U>that a facility has negotiated with all third-party payers for a facili-</U></B> 56 <B><U>ty item or service.</U></B> </PRE><P CLASS="brk"><PRE WIDTH="99"> S. 7479 3 1 <B><U>(e) "De-identified minimum negotiated charge" means the lowest charge</U></B> 2 <B><U>that a facility has negotiated with all third-party payers for a facili-</U></B> 3 <B><U>ty item or service.</U></B> 4 <B><U>(f) "Discounted cash price" means the charge that applies to an indi-</U></B> 5 <B><U>vidual who pays cash, or cash equivalent, for a facility item or</U></B> 6 <B><U>service.</U></B> 7 <B><U>(g) "Facility" includes the following:</U></B> 8 <B><U>(i) general hospitals as defined in section twenty-eight hundred one</U></B> 9 <B><U>of this article; and</U></B> 10 <B><U>(ii) any hospital, as defined in section twenty-eight hundred one of</U></B> 11 <B><U>this article, to which the department determines this section should</U></B> 12 <B><U>apply.</U></B> 13 <B><U>(h) "Gross charge" means the charge for a facility item or service</U></B> 14 <B><U>that is reflected on a facility's chargemaster, absent any discounts.</U></B> 15 <B><U>(i) "Facility items and services" and any variation of this phrase</U></B> 16 <B><U>means all items and services, including individual items and services</U></B> 17 <B><U>and service packages, that may be provided by a facility to a patient in</U></B> 18 <B><U>connection with an inpatient admission or an outpatient department visit</U></B> 19 <B><U>for which the facility has established a standard charge. This includes,</U></B> 20 <B><U>but is not limited to:</U></B> 21 <B><U>(i) supplies and procedures;</U></B> 22 <B><U>(ii) room and board;</U></B> 23 <B><U>(iii) use of the facility and other areas, the charges for which are</U></B> 24 <B><U>generally referred to as facility fees;</U></B> 25 <B><U>(iv) services of physicians and non-physician practitioners, employed</U></B> 26 <B><U>by the facility, the charges for which are generally referred to as</U></B> 27 <B><U>professional charges; and</U></B> 28 <B><U>(v) any other item or service for which a facility has established a</U></B> 29 <B><U>standard charge.</U></B> 30 <B><U>(j) "Machine-readable format" means a digital representation of data</U></B> 31 <B><U>or information in a file that can be imported or read into a computer</U></B> 32 <B><U>system for further processing, including .XML, .JSON, and .CSV formats.</U></B> 33 <B><U>(k) "Payer-specific negotiated charge" means the charge that a facili-</U></B> 34 <B><U>ty has negotiated with a third-party payer for a facility item or</U></B> 35 <B><U>service.</U></B> 36 <B><U>(l) "Service package" means an aggregation of individual facility</U></B> 37 <B><U>items and services into a single service with a single charge.</U></B> 38 <B><U>(m) "Shoppable service" means a service that may be scheduled by a</U></B> 39 <B><U>health care consumer in advance.</U></B> 40 <B><U>(n) "Standard charge" means the regular rate established by the facil-</U></B> 41 <B><U>ity for a facility item or service provided to a specific group of</U></B> 42 <B><U>paying patients. This term includes all of the following, as defined</U></B> 43 <B><U>under this section:</U></B> 44 <B><U>(i) the gross charge;</U></B> 45 <B><U>(ii) the payer-specific negotiated charge;</U></B> 46 <B><U>(iii) the de-identified minimum negotiated charge;</U></B> 47 <B><U>(iv) the de-identified maximum negotiated charge; and</U></B> 48 <B><U>(v) the discounted cash price.</U></B> 49 <B><U>(o) "Third-party payer" means an entity that is, by statute, contract,</U></B> 50 <B><U>or agreement, legally responsible for payment of a claim for a facility</U></B> 51 <B><U>item or service.</U></B> 52 <B><U>2. Notwithstanding any other law, a facility must make public the</U></B> 53 <B><U>following:</U></B> 54 <B><U>(a) a digital file in a machine-readable format that contains a list</U></B> 55 <B><U>of all standard charges for all facility items and services as provided</U></B> 56 <B><U>in subdivision three of this section; and</U></B> </PRE><P CLASS="brk"><PRE WIDTH="99"> S. 7479 4 1 <B><U>(b) a consumer-friendly list of standard charges for a limited set of</U></B> 2 <B><U>shoppable services as provided in subdivision three of this section.</U></B> 3 <B><U>3. (a) A facility shall maintain a list of all standard charges for</U></B> 4 <B><U>all facility items and services in accordance with this section. This</U></B> 5 <B><U>list must include, as applicable:</U></B> 6 <B><U>(i) a description of each facility item or service provided by the</U></B> 7 <B><U>facility; and</U></B> 8 <B><U>(ii) the following charges for each individual facility item or</U></B> 9 <B><U>service when provided in either an inpatient setting or an outpatient</U></B> 10 <B><U>department setting, as applicable:</U></B> 11 <B><U>(A) the gross charge;</U></B> 12 <B><U>(B) the de-identified minimum negotiated charge;</U></B> 13 <B><U>(C) the de-identified maximum negotiated charge;</U></B> 14 <B><U>(D) the discounted cash price; and</U></B> 15 <B><U>(E) the payer-specific negotiated charge, listed by the name of the</U></B> 16 <B><U>third-party payer and plan associated with the charge and displayed in a</U></B> 17 <B><U>manner that clearly associates the charge with each third-party payer</U></B> 18 <B><U>and plan; and</U></B> 19 <B><U>(iii) any code used by the facility for purposes of accounting or</U></B> 20 <B><U>billing for the facility item or service, including, but not limited to,</U></B> 21 <B><U>the Current Procedural Terminology (CPT) code, the Healthcare Common</U></B> 22 <B><U>Procedure Coding System (HCPCS) code, the Diagnosis Related Group (DRG)</U></B> 23 <B><U>code, the National Drug Code (NDC), or other common payer identifier.</U></B> 24 <B><U>(b) The standard charges contained in the list required to be main-</U></B> 25 <B><U>tained by a facility under paragraph (a) of this subdivision must</U></B> 26 <B><U>reflect the standard charges applicable to that location of the facili-</U></B> 27 <B><U>ty, regardless of whether the facility operates in more than one</U></B> 28 <B><U>location or operates under the same license or approval as another</U></B> 29 <B><U>facility.</U></B> 30 <B><U>(c) The information contained in the list required under paragraph (a)</U></B> 31 <B><U>of this subdivision must be published in a single digital file that is</U></B> 32 <B><U>in a machine-readable format.</U></B> 33 <B><U>(d) The list required under paragraph (a) of this subdivision must be</U></B> 34 <B><U>displayed in a prominent location on the home page of the facility's</U></B> 35 <B><U>publicly accessible internet website or accessible by selecting a dedi-</U></B> 36 <B><U>cated link that is prominently displayed on the home page of the facili-</U></B> 37 <B><U>ty's publicly accessible internet website. If the facility operates</U></B> 38 <B><U>multiple locations and maintains a single internet website, the list</U></B> 39 <B><U>required under paragraph (a) of this subdivision must be posted for each</U></B> 40 <B><U>location the facility operates in a manner that clearly associates the</U></B> 41 <B><U>list with the applicable location of the facility.</U></B> 42 <B><U>(e) The list required under paragraph (a) of this subdivision must:</U></B> 43 <B><U>(i) be available:</U></B> 44 <B><U>(A) free of charge;</U></B> 45 <B><U>(B) without having to register or establish a user account or pass-</U></B> 46 <B><U>word;</U></B> 47 <B><U>(C) without having to submit personal identifying information;</U></B> 48 <B><U>(D) without having to enter a code to access the list; and</U></B> 49 <B><U>(E) without having to overcome any other barrier that limits the</U></B> 50 <B><U>availability or accessibility of the list;</U></B> 51 <B><U>(ii) be accessible to a common commercial operator of an internet</U></B> 52 <B><U>search engine to the extent necessary for the search engine to index the</U></B> 53 <B><U>list and display the list as a result in response to a search query of a</U></B> 54 <B><U>user of the search engine;</U></B> 55 <B><U>(iii) be formatted in a manner prescribed by the department under</U></B> 56 <B><U>subdivision five of this section;</U></B> </PRE><P CLASS="brk"><PRE WIDTH="99"> S. 7479 5 1 <B><U>(iv) be digitally searchable; and</U></B> 2 <B><U>(v) use the following naming convention specified by the Centers for</U></B> 3 <B><U>Medicare and Medicaid Services, specifically: <ein>_<facility-</U></B> 4 <B><U>name>_standardcharges.{json/xml/csv}.</U></B> 5 <B><U>(f) The facility must update the list required under paragraph (a) of</U></B> 6 <B><U>this subdivision at least once a year. The facility must clearly indi-</U></B> 7 <B><U>cate the date on which the list was most recently updated, either within</U></B> 8 <B><U>the list itself or in a manner that is clearly associated with the list.</U></B> 9 <B><U>4. (a) Except as provided by paragraph (c) of this subdivision, a</U></B> 10 <B><U>facility shall maintain and make publicly available a list of the stand-</U></B> 11 <B><U>ard charges described in subparagraphs (i), (ii), (iii), (iv) and (v) of</U></B> 12 <B><U>paragraph (d) of this subdivision for at least three hundred shoppable</U></B> 13 <B><U>services provided by the facility. The facility may select the shoppable</U></B> 14 <B><U>services to be included in the list, except that the list must include:</U></B> 15 <B><U>(i) the seventy services specified as shoppable services by the</U></B> 16 <B><U>Centers for Medicare and Medicaid Services; or</U></B> 17 <B><U>(ii) if the facility does not provide all of the seventy services</U></B> 18 <B><U>specified as shoppable services by the Centers for Medicare and Medicaid</U></B> 19 <B><U>Services, as many of those shoppable services the facility does provide.</U></B> 20 <B><U>(b) In selecting a shoppable service for purposes of inclusion in the</U></B> 21 <B><U>list required under paragraph (a) of this subdivision, a facility must:</U></B> 22 <B><U>(i) consider how frequently the facility provides the service and the</U></B> 23 <B><U>facility's billing rate for that service; and</U></B> 24 <B><U>(ii) prioritize the selection of services that are among the services</U></B> 25 <B><U>most frequently provided by the facility.</U></B> 26 <B><U>(c) If a facility does not provide three hundred shoppable services,</U></B> 27 <B><U>the facility must maintain a list of all of the shoppable services that</U></B> 28 <B><U>the facility provides in a manner that otherwise complies with the</U></B> 29 <B><U>requirements of paragraph (a) of this subdivision.</U></B> 30 <B><U>(d) The list required under paragraph (a) or (c) of this subdivision,</U></B> 31 <B><U>as applicable, must include:</U></B> 32 <B><U>(i) a plain-language description of each shoppable service included on</U></B> 33 <B><U>the list;</U></B> 34 <B><U>(ii) the payer-specified negotiated charge that applies to each shop-</U></B> 35 <B><U>pable service included on the list, and any corresponding ancillary</U></B> 36 <B><U>service as applicable, listed by the name of the third-party payer and</U></B> 37 <B><U>plan associated with the charge and displayed in a manner that clearly</U></B> 38 <B><U>associates the charge with the third-party payer and plan;</U></B> 39 <B><U>(iii) the discounted cash price that applies to each shoppable service</U></B> 40 <B><U>included on the list, and any corresponding ancillary service as appli-</U></B> 41 <B><U>cable, or if the facility does not offer a discounted cash price for one</U></B> 42 <B><U>or more of the shoppable or ancillary services on the list, the gross</U></B> 43 <B><U>charge for the shoppable or ancillary service, as applicable;</U></B> 44 <B><U>(iv) the de-identified minimum negotiated charge that applies to each</U></B> 45 <B><U>shoppable service included on the list and any corresponding ancillary</U></B> 46 <B><U>service, as applicable;</U></B> 47 <B><U>(v) the de-identified maximum negotiated charge that applies to each</U></B> 48 <B><U>shoppable service included on the list and any corresponding ancillary</U></B> 49 <B><U>service, as applicable;</U></B> 50 <B><U>(vi) any code used by the facility for purposes of accounting or bill-</U></B> 51 <B><U>ing for each shoppable service included on the list and any ancillary</U></B> 52 <B><U>service, including the Current Procedural Terminology (CPT) code, the</U></B> 53 <B><U>Healthcare Common Procedure Coding System (HCPCS) code, the Diagnosis</U></B> 54 <B><U>Related Group (DRG) code, the National Drug Code (NDC), or other common</U></B> 55 <B><U>payer identifier;</U></B> </PRE><P CLASS="brk"><PRE WIDTH="99"> S. 7479 6 1 <B><U>(vii) each location at which the facility provides the shoppable</U></B> 2 <B><U>service and whether the standard charges identified in subparagraphs</U></B> 3 <B><U>(ii), (iii), (iv) and (v) of this paragraph apply at that location to</U></B> 4 <B><U>the provision of that shoppable service in an inpatient setting, an</U></B> 5 <B><U>outpatient department setting, or in both of those settings, as applica-</U></B> 6 <B><U>ble; and</U></B> 7 <B><U>(viii) if applicable, indicate if one of more of the shoppable</U></B> 8 <B><U>services specified by the Centers for Medicare and Medicaid Services is</U></B> 9 <B><U>not provided by the facility.</U></B> 10 <B><U>(e) The list required under paragraph (a) or (c) of this subdivision,</U></B> 11 <B><U>as applicable, must be displayed in a prominent location on the home</U></B> 12 <B><U>page of the facility's publicly accessible internet website or accessi-</U></B> 13 <B><U>ble by selecting a dedicated link that is prominently displayed on the</U></B> 14 <B><U>home page of the facility's publicly accessible internet website. If the</U></B> 15 <B><U>facility operates multiple locations and maintains a single internet</U></B> 16 <B><U>website, the list required under paragraph (a) or (c) of this subdivi-</U></B> 17 <B><U>sion, as applicable, must be posted for each location the facility oper-</U></B> 18 <B><U>ates in a manner that clearly associates the list with the applicable</U></B> 19 <B><U>location of the facility.</U></B> 20 <B><U>(f) The list required under paragraph (a) or (c) of this subdivision,</U></B> 21 <B><U>as applicable, must be:</U></B> 22 <B><U>(i) easily accessible and available:</U></B> 23 <B><U>(A) free of charge;</U></B> 24 <B><U>(B) without having to register or establish a user account or pass-</U></B> 25 <B><U>word;</U></B> 26 <B><U>(C) without having to submit personal identifying information;</U></B> 27 <B><U>(D) without having to enter a code to access the list; and</U></B> 28 <B><U>(E) without having to overcome any other barrier that limits the</U></B> 29 <B><U>availability or accessibility of the list; and</U></B> 30 <B><U>(ii) digitally searchable by service description, billing code, and</U></B> 31 <B><U>payer;</U></B> 32 <B><U>(iii) accessible to a common commercial operator of an internet search</U></B> 33 <B><U>engine to the extent necessary for the search engine to index the list</U></B> 34 <B><U>and display the list as a result in response to a search query of a user</U></B> 35 <B><U>of the search engine;</U></B> 36 <B><U>(iv) formatted in a manner that is consistent with the format</U></B> 37 <B><U>prescribed by the department under subdivision five of this section; and</U></B> 38 <B><U>(v) updated at least once a year. The facility must clearly indicate</U></B> 39 <B><U>the date on which the list was most recently updated, either within the</U></B> 40 <B><U>list itself or in a manner that is clearly associated with the list.</U></B> 41 <B><U>(g) Notwithstanding any other provision of this section, a facility is</U></B> 42 <B><U>considered to meet the requirements of this subdivision if the facility</U></B> 43 <B><U>maintains, as determined by the department, an internet-based price</U></B> 44 <B><U>estimator tool that meets the following requirements:</U></B> 45 <B><U>(i) provides a reasonably accurate cost estimate for each shoppable</U></B> 46 <B><U>service and any corresponding ancillary service included on the list</U></B> 47 <B><U>maintained by the facility under paragraph (a) or (c) of this subdivi-</U></B> 48 <B><U>sion, as applicable;</U></B> 49 <B><U>(ii) allows a person to obtain a reasonably accurate estimate of the</U></B> 50 <B><U>amount the person will be obligated to pay the facility if the person</U></B> 51 <B><U>elects to use the facility to provide the service; and</U></B> 52 <B><U>(iii) is prominently displayed on the facility's publicly accessible</U></B> 53 <B><U>internet website and is accessible to the public without charge and</U></B> 54 <B><U>without having to register or establish a user account or password.</U></B> 55 <B><U>5. In prescribing the format of the list under subparagraph (iii) of</U></B> 56 <B><U>paragraph (e) of subdivision three and subparagraph (iv) of paragraph</U></B> </PRE><P CLASS="brk"><PRE WIDTH="99"> S. 7479 7 1 <B><U>(f) of subdivision four of this section, the department shall develop a</U></B> 2 <B><U>template that each facility must use in formatting the list, and in</U></B> 3 <B><U>developing this template, the department must:</U></B> 4 <B><U>(a) consider any applicable federal guidelines for formatting similar</U></B> 5 <B><U>lists required by federal law or regulation and ensure that the design</U></B> 6 <B><U>of the template enables healthcare researchers to compare the charges</U></B> 7 <B><U>contained in the lists maintained by each facility; and</U></B> 8 <B><U>(b) design the template to be substantially similar to the template</U></B> 9 <B><U>used by the Centers for Medicare and Medicaid Services for purposes</U></B> 10 <B><U>similar to those of this section, if the department determines that</U></B> 11 <B><U>designing the template in that manner serves the purposes of paragraph</U></B> 12 <B><U>(a) of this subdivision and that the department benefits from developing</U></B> 13 <B><U>and requiring that substantially similar design.</U></B> 14 <B><U>6. Each time a facility updates a list as required under paragraph (f)</U></B> 15 <B><U>of subdivision three and subparagraph (v) of paragraph (f) of subdivi-</U></B> 16 <B><U>sion four of this section, the facility shall submit the updated list to</U></B> 17 <B><U>the department. The department may prescribe the form in which the</U></B> 18 <B><U>updated list must be submitted to the department.</U></B> 19 <B><U>7. (a) The department shall monitor each facility's compliance with</U></B> 20 <B><U>the requirements of this section using, but not limited to, the follow-</U></B> 21 <B><U>ing methods:</U></B> 22 <B><U>(i) evaluating complaints made by individuals or entities to the</U></B> 23 <B><U>department, including through a complaint form on the department's</U></B> 24 <B><U>internet website;</U></B> 25 <B><U>(ii) reviewing any analysis prepared by individuals or entities</U></B> 26 <B><U>regarding noncompliance with this section;</U></B> 27 <B><U>(iii) auditing the internet websites of facilities for compliance with</U></B> 28 <B><U>this section; and</U></B> 29 <B><U>(iv) confirming that each facility submitted the lists required under</U></B> 30 <B><U>subdivision six of this section.</U></B> 31 <B><U>(b) If the department determines that any facility is not in compli-</U></B> 32 <B><U>ance with any provision of this section, the department may take any of</U></B> 33 <B><U>the following actions, without regard to the order of the actions:</U></B> 34 <B><U>(i) provide a written notice to the facility that clearly explains the</U></B> 35 <B><U>manner in which the facility is not in compliance with this section;</U></B> 36 <B><U>(ii) request a corrective action plan from the facility if the facili-</U></B> 37 <B><U>ty is in material noncompliance with this section, as determined under</U></B> 38 <B><U>subdivision eight of this section;</U></B> 39 <B><U>(iii) share information with government agencies, the Centers for</U></B> 40 <B><U>Medicare and Medicaid Services, or other entities as it deems appropri-</U></B> 41 <B><U>ate; and</U></B> 42 <B><U>(iv) impose an administrative penalty on the facility and publicize</U></B> 43 <B><U>the penalty on the commission's internet website if the facility fails</U></B> 44 <B><U>to respond to the department's request to submit a corrective action</U></B> 45 <B><U>plan or comply with the requirements of a corrective action plan submit-</U></B> 46 <B><U>ted to the department, pursuant to subdivision nine of this section.</U></B> 47 <B><U>8. (a) A facility is in material noncompliance with this section if</U></B> 48 <B><U>the facility fails to:</U></B> 49 <B><U>(i) comply with the requirements of subdivision two of this section;</U></B> 50 <B><U>or</U></B> 51 <B><U>(ii) publicize the facility's standard charges in the form and manner</U></B> 52 <B><U>required under subdivision three or four of this section.</U></B> 53 <B><U>(b) If the department determines that a facility is in material</U></B> 54 <B><U>noncompliance with this section, the department may issue a notice of</U></B> 55 <B><U>material noncompliance to the facility and request that the facility</U></B> 56 <B><U>submit a corrective action plan. The notice must indicate the form and</U></B> </PRE><P CLASS="brk"><PRE WIDTH="99"> S. 7479 8 1 <B><U>manner in which the corrective action plan must be submitted to the</U></B> 2 <B><U>department, and clearly state the date by which the facility must submit</U></B> 3 <B><U>the plan.</U></B> 4 <B><U>(c) A facility that receives a notice under paragraph (b) of this</U></B> 5 <B><U>subdivision must:</U></B> 6 <B><U>(i) submit a corrective action plan in the form and manner, and by the</U></B> 7 <B><U>specified date, prescribed by the notice of violation; and</U></B> 8 <B><U>(ii) as soon as practicable after submission of a corrective action</U></B> 9 <B><U>plan to the department, act to comply with the plan.</U></B> 10 <B><U>(d) A corrective action plan submitted to the department must:</U></B> 11 <B><U>(i) describe in detail the corrective action the facility will take to</U></B> 12 <B><U>address any violation identified by the department in the notice</U></B> 13 <B><U>provided under paragraph (b) of this subdivision; and</U></B> 14 <B><U>(ii) provide a date by which the facility will complete the corrective</U></B> 15 <B><U>action plan.</U></B> 16 <B><U>(e) A corrective action plan is subject to review and approval by the</U></B> 17 <B><U>department. After the department reviews and approves a facility's</U></B> 18 <B><U>corrective action plan, the department may monitor and evaluate the</U></B> 19 <B><U>facility's compliance with the plan.</U></B> 20 <B><U>(f) A facility is considered to have failed to respond to the depart-</U></B> 21 <B><U>ment's request to submit a corrective action plan if the facility fails</U></B> 22 <B><U>to submit a corrective action plan in the form and manner specified in</U></B> 23 <B><U>the notice under paragraph (b) of this subdivision or by the date speci-</U></B> 24 <B><U>fied in the notice under paragraph (b) of this subdivision.</U></B> 25 <B><U>(g) A facility is considered to have failed to comply with a correc-</U></B> 26 <B><U>tive action plan if the facility fails to address a violation within the</U></B> 27 <B><U>specified period of time contained in the plan.</U></B> 28 <B><U>(h) A facility that is in material noncompliance with this section</U></B> 29 <B><U>shall be placed onto a list of facilities in material noncompliance that</U></B> 30 <B><U>is published on the department's public internet website, except where:</U></B> 31 <B><U>(i) the facility in material noncompliance has submitted a corrective</U></B> 32 <B><U>action plan that has been approved by the department; and</U></B> 33 <B><U>(ii) the facility remains compliant with this section.</U></B> 34 <B><U>9. (a) The department may impose an administrative penalty on a facil-</U></B> 35 <B><U>ity if the facility fails to:</U></B> 36 <B><U>(i) respond to the department's request to submit a corrective action</U></B> 37 <B><U>plan; or</U></B> 38 <B><U>(ii) comply with the requirements of a corrective action plan submit-</U></B> 39 <B><U>ted to the department.</U></B> 40 <B><U>(b) The department may impose an administrative penalty on a facility</U></B> 41 <B><U>for a violation of each requirement of this section. The department</U></B> 42 <B><U>shall set the penalty in an amount sufficient to ensure compliance by</U></B> 43 <B><U>the facility with the provisions of this section subject to the limita-</U></B> 44 <B><U>tions in paragraph (c) of this subdivision.</U></B> 45 <B><U>(c) Using the most recently updated number of beds reported to the</U></B> 46 <B><U>Centers for Medicaid and Medicare Services, the department, or another</U></B> 47 <B><U>entity designated by the department, for each day a facility is deter-</U></B> 48 <B><U>mined by the department to be out of compliance, the daily civil mone-</U></B> 49 <B><U>tary penalty may not exceed:</U></B> 50 <B><U>(i) three hundred dollars for each day the facility violated this</U></B> 51 <B><U>section for a facility with a number of beds equal to or less than thir-</U></B> 52 <B><U>ty, even if the facility is in violation of multiple discrete require-</U></B> 53 <B><U>ments of this section;</U></B> 54 <B><U>(ii) the number of beds multiplied by ten dollars for each day the</U></B> 55 <B><U>facility violated this section for a facility with at least thirty-one</U></B> 56 <B><U>beds and up to and including five hundred fifty beds, even if the facil-</U></B> </PRE><P CLASS="brk"><PRE WIDTH="99"> S. 7479 9 1 <B><U>ity is in violation of multiple discrete requirements of this section;</U></B> 2 <B><U>or</U></B> 3 <B><U>(iii) five thousand dollars for each day the facility violated this</U></B> 4 <B><U>section for a facility with a number of beds greater than five hundred</U></B> 5 <B><U>fifty, even if the facility is in violation of multiple discrete</U></B> 6 <B><U>requirements of this section.</U></B> 7 <B><U>(d) Each day a violation continues is considered a separate violation.</U></B> 8 <B><U>(e) In determining the amount of the penalty, the department shall</U></B> 9 <B><U>consider:</U></B> 10 <B><U>(i) previous violations by the facility operator;</U></B> 11 <B><U>(ii) the seriousness of the violation;</U></B> 12 <B><U>(iii) the demonstrated good faith of the facility's operator; and</U></B> 13 <B><U>(iv) any other matters as justice may require.</U></B> 14 <B><U>(f) An administrative penalty collected under this section shall be</U></B> 15 <B><U>appropriated only to the department.</U></B> 16 <B><U>10. The department may prepare and submit a report of recommendations</U></B> 17 <B><U>for amending this section to the governor, the temporary president of</U></B> 18 <B><U>the senate, and the speaker of the assembly, including recommendations</U></B> 19 <B><U>in response to amendments by the Centers for Medicare and Medicaid</U></B> 20 <B><U>Services to 45 C.F.R. Part 180.</U></B> 21 <B><U>11. No facility shall enforce any clause mandating mediation or alter-</U></B> 22 <B><U>native dispute resolution in any facility document, including contracts,</U></B> 23 <B><U>agreements, statements, or bills, in an action arising from patient or</U></B> 24 <B><U>patient guarantor non-payment of facility items or services if that</U></B> 25 <B><U>facility is in material noncompliance with this section on the date that</U></B> 26 <B><U>the relevant facility items or services are purchased from a provider to</U></B> 27 <B><U>a patient by the facility in material noncompliance.</U></B> 28 <B><U>12. (a) If a patient believes that a facility was in material noncom-</U></B> 29 <B><U>pliance with this section on or after the date that the relevant items</U></B> 30 <B><U>or services are purchased by or provided to the patient, and the facili-</U></B> 31 <B><U>ty takes a collections action, as defined in this section, against the</U></B> 32 <B><U>patient or patient guarantor, and the patient or patient guarantor</U></B> 33 <B><U>believes that the material noncompliance is related to the relevant</U></B> 34 <B><U>facility item or service, the patient or patient guarantor may file suit</U></B> 35 <B><U>to determine if the facility was in material noncompliance with this</U></B> 36 <B><U>section. The facility shall not take a collections action against the</U></B> 37 <B><U>patient or patient guarantor related to the relevant facility item or</U></B> 38 <B><U>service, and must stay any related pending collections action against</U></B> 39 <B><U>the patient or patient guarantor, while the lawsuit is pending.</U></B> 40 <B><U>(b) A facility that has been found by a court to be in material</U></B> 41 <B><U>noncompliance with this section:</U></B> 42 <B><U>(i) shall refund the third-party payer any amount of the medical debt</U></B> 43 <B><U>the third-party payer has paid and shall pay a penalty to the patient or</U></B> 44 <B><U>patient guarantor in an amount equal to the total amount of the debt;</U></B> 45 <B><U>(ii) shall dismiss or cause to be dismissed any court action and</U></B> 46 <B><U>collections action with prejudice and pay any attorney fees and costs</U></B> 47 <B><U>incurred by the patient or patient guarantor relating to the action; and</U></B> 48 <B><U>(iii) remove or cause to be removed from the patient's or patient</U></B> 49 <B><U>guarantor's credit report any report made to a consumer reporting agency</U></B> 50 <B><U>relating to the debt.</U></B> 51 <B><U>13. Nothing in this section:</U></B> 52 <B><U>(a) prohibits a facility from billing a patient, patient guarantor, or</U></B> 53 <B><U>third-party payer, including health insurer, for items or services</U></B> 54 <B><U>provided to the patient; or</U></B> </PRE><P CLASS="brk"><PRE WIDTH="99"> S. 7479 10 1 <B><U>(b) requires a facility to refund any payment made to the hospital for</U></B> 2 <B><U>items or services provided to the patient, so long as no collection</U></B> 3 <B><U>action is taken in violation of this section.</U></B> 4 § 5. This act shall take effect one year after it shall have become a 5 law. |
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