Substitute Senate Bill No. 496 aims to improve hospital financial assistance programs for uninsured patients by establishing new guidelines and reimbursement mechanisms, effective October 1, 2026. The bill defines "hospital financial assistance" and sets eligibility criteria based on income relative to the federal poverty level, mandating that hospitals provide care at no cost for uninsured patients earning up to 200% of the poverty level and subsidized care for those earning up to 300%. It also caps annual payments for patients under 200% of the poverty level who are ineligible for assistance at 2% of their income, with remaining balances forgiven after 36 months. The bill exempts homeless patients from documentation requirements and mandates that hospitals provide information about financial assistance in multiple languages.

Additionally, the bill introduces provisions for reimbursement through Medicaid's disproportionate share hospital payments and requires the Commissioner of Social Services to amend the Medicaid state plan accordingly. It modifies the appeals process for hospitals aggrieved by the commissioner's decisions, allowing for rehearings and binding arbitration. The bill also repeals certain existing language in section 17b-238 of the general statutes, replacing it with new provisions related to the financial assistance program. Furthermore, it allows hospitals to accept various forms of income verification documentation while exempting homeless patients from these requirements, and mandates that hospitals provide information about financial assistance programs in multiple languages, ensuring compliance with the Americans with Disabilities Act.