PRINTER'S NO. 67
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
78
Session of
2023
INTRODUCED BY VENKAT, BULLOCK, KHAN, KOSIEROWSKI, PISCIOTTANO,
SCHLOSSBERG, SIEGEL, RABB, KINSEY, MADDEN, PROBST, SANCHEZ,
PARKER, HILL-EVANS, N. NELSON, DELLOSO, WARREN, ABNEY,
T. DAVIS, SMITH-WADE-EL, BIZZARRO, FLEMING, INNAMORATO,
MALAGARI, KINKEAD, McNEILL, GUENST, GREEN, HADDOCK, SOLOMON,
BOROWSKI, SHUSTERMAN, FIEDLER, FRIEL, SALISBURY, ZABEL,
MADSEN, KENYATTA, STURLA, MARKOSEK, KAZEEM, CONKLIN AND
STEELE, MARCH 7, 2023
REFERRED TO COMMITTEE ON HEALTH, MARCH 7, 2023
AN ACT
Establishing the Medical Debt Relief Program; imposing duties on
the Department of Health; and making an appropriation.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as the Medical Debt
Relief Act.
Section 2. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Bad debt expense." The cost of care for which a health care
provider expected payment from the patient or a third-party
payor, but which the health care provider subsequently
determines to be uncollectible.
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"Department." The Department of Health of the Commonwealth.
"Eligible resident." An individual eligible for relief who
meets all of the following conditions:
(1) Is a resident of this Commonwealth.
(2) Has a household income at or below 400% of the
Federal poverty guidelines or has medical debt equal to 5% or
more of the individual's household income.
"Health care provider." Either of the following:
(1) A health care provider, as defined in section 1201
of the act of May 17, 1921 (P.L.682, No.284), known as The
Insurance Company Law of 1921.
(2) An emergency medical services agency, as defined in
35 Pa.C.S. ยง 8103 (relating to definitions).
"Medical debt." Debt arising from the receipt of health care
services.
"Medical debt relief coordinator." A person, company,
partnership or other entity that is able to discharge medical
debt of an eligible resident in a manner that does not result in
a taxable event for the eligible resident.
"Program." The Medical Debt Relief Program established under
section 3.
"Relief." The discharge of medical debt.
Section 3. Medical Debt Relief Program.
(a) Establishment and purpose.--The Medical Debt Relief
Program is established within the department for the purpose of
discharging medical debt of eligible residents by contracting
with a medical debt relief coordinator as described in
subsection (c).
(b) Use of money.--Money allocated to the program shall be
used exclusively for the program, including contracting with a
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medical debt relief coordinator and providing money to be used
by the medical debt relief coordinator to discharge medical debt
of eligible residents. Money used in contracting with a medical
debt relief coordinator may also be used for the payment of
services provided by the medical debt relief coordinator to
discharge medical debt of eligible residents based on a budget
approved by the department.
(c) Contracts.--
(1) The department is authorized to and shall enter into
a contract with a medical debt relief coordinator to purchase
and discharge medical debt owed by an eligible resident with
money allocated for the program.
(2) The department shall implement a competitive bidding
process to determine which medical debt relief coordinator to
use, unless the department determines that only a single
medical debt relief coordinator has the capacity and
willingness to carry out the duties specified in this act.
(3) In contracting with the department, a medical debt
relief coordinator shall adhere to the following:
(i) The medical debt relief coordinator shall review
the medical debt accounts of each health care provider
willing to sell medical debt accounts in this
Commonwealth.
(ii) If a health care provider identifies the
accounts described in subparagraph (i) as a bad debt
expense or considers the accounts described in
subparagraph (i) as dormant and owed by an eligible
resident, the medical debt relief coordinator may elect
to buy the dischargeable medical debt from the health
care provider.
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(iii) After the purchase and discharge of medical
debt from a health care provider, the medical debt relief
coordinator shall notify all eligible residents whose
medical debt has been discharged under the program, in a
manner approved by the department, that they no longer
have specified medical debt owed to the relevant health
care provider.
(iv) A medical debt relief coordinator shall make a
best effort to ensure parity and equity in the purchasing
and discharging of medical debt to ensure that all
eligible residents have an equal opportunity of receiving
relief regardless of their geographical location or
identities and characteristics as identified in section 2
of the act of October 27, 1955 (P.L.744, No.222), known
as the Pennsylvania Human Relations Act.
(v) A medical debt relief coordinator shall report
to the department the summary statistics regarding
eligible residents whose medical debt has been
discharged.
(vi) A medical debt relief coordinator may not
attempt to seek payment from an eligible resident for
medical debt purchased by the medical debt relief
coordinator.
(4) A medical debt relief coordinator shall continue to
fulfill its contractual obligations to the department until
all money contracted to the medical debt relief coordinator
is exhausted, regardless of whether money allocated to the
program has been exhausted.
(d) Breach of contract.--If a medical debt relief
coordinator attempts to seek payment from an eligible resident
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for medical debt purchased by the medical debt relief
coordinator or fails to carry out the responsibilities described
in its contract with the department, the medical debt relief
coordinator shall be considered in breach of contract and the
contract provisions that apply in the case of a breach of
contract shall apply.
Section 4. Reports.
(a) Requirement.--Beginning one year after the effective
date of this section and annually thereafter for as long as
medical debt relief coordinators are fulfilling their
contractual obligations under this act, the department shall
submit an annual report regarding the program in accordance with
this section.
(b) Contents.--Each report under this section shall contain
the following information for the annual period covered by the
report:
(1) The amount of medical debt purchased and discharged
under the program.
(2) The number of eligible residents who received relief
under the program.
(3) The characteristics of the eligible residents as
described in section 3(c)(3)(iv).
(4) The number of and characteristics of health care
providers from whom medical debt was purchased and
discharged.
(5) The number of and characteristics of medical debt
relief coordinators contracted with for the purposes of
purchasing and discharging medical debt.
(c) Submittal.--Each report under this section shall be
submitted to the following:
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(1) The Governor.
(2) The President pro tempore of the Senate.
(3) The Speaker of the House of Representatives.
(4) The Majority Leader and Minority Leader of the
Senate.
(5) The Majority Leader and Minority Leader of the House
of Representatives.
(6) The chairperson and minority chairperson of the
Health and Human Services Committee of the Senate.
(7) The chairperson and minority chairperson of the
Health Committee of the House of Representatives.
Section 5. Appropriation.
The sum of $15,000,000 is appropriated from the General Fund
to the department for the program.
Section 6. Effective date.
This act shall take effect immediately.
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