SENATE JUDICIARY COMMITTEE SUBSTITUTE FOR

SENATE BILL 71

55th legislature - STATE OF NEW MEXICO - first session, 2021

 

 

 

 

 

 

 

AN ACT

RELATING TO CONSUMER PROTECTION; ENACTING THE PATIENTS' DEBT COLLECTION PROTECTION ACT; PREVENTING COLLECTION FROM INDIGENT PATIENTS; REQUIRING HEALTH CARE FACILITIES TO SCREEN PATIENTS FOR ASSISTANCE ELIGIBILITY; REQUIRING HEALTH CARE FACILITIES TO PROVIDE PRICE AND PAYMENT INFORMATION; PROVIDING FOR PRICING PARITY; REQUIRING HEALTH CARE FACILITIES AND THIRD-PARTY HEALTH CARE PROVIDERS TO REPORT HOW CERTAIN PUBLIC FUNDS ARE SPENT; LIMITING ENFORCEABILITY OF CERTAIN JUDGMENTS; MAKING VIOLATIONS OF THE PATIENTS' DEBT COLLECTION PROTECTION ACT AND THE COLLECTION AGENCY REGULATORY ACT UNFAIR OR DECEPTIVE TRADE PRACTICES; ADDING TO THE DEFINITION OF "COLLECTION AGENCY" IN THE COLLECTION AGENCY REGULATORY ACT; INCREASING SURETY BOND COVERAGE REQUIREMENTS; REMOVING ATTORNEY FEES AND COSTS FOR CERTAIN SUITS BY COLLECTION AGENCIES; AMENDING AND ENACTING SECTIONS OF THE NMSA 1978.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

         SECTION 1. A new section of Chapter 57 NMSA 1978 is enacted to read:

         "[NEW MATERIAL] SHORT TITLE.--Sections 1 through 13 of this act may be cited as the "Patients' Debt Collection Protection Act"."

         SECTION 2. A new section of Chapter 57 NMSA 1978 is enacted to read:

         "[NEW MATERIAL] DEFINITIONS.--As used in the Patients' Debt Collection Protection Act:

                   A. "collection action" means any of the following:

                               (1) selling a person's medical debt to another party, including a medical debt collector;

                               (2) reporting adverse information about a patient to a consumer reporting agency; or

                               (3) actions that require a legal or judicial process, including:

                                         (a) placing a lien on a person's property;

                                         (b) attaching or seizing a person's bank account or any other personal property;

                                         (c) commencing a civil action against a person; or

                                         (d) garnishing a person's wages;

                   B. "consumer" means a natural person;

                   C. "consumer reporting agency" means a person that, for monetary fees, dues or on a cooperative nonprofit basis, regularly engages in whole or in part in the practice of assembling or evaluating consumer credit information or other information on consumers for the purpose of furnishing consumer reports to third parties;

                   D. "department" means the human services department;

                   E. "gross charges" means a health care facility's full, established price for health care services that the health care facility charges uninsured patients before applying any contractual allowances, discounts or deductions;

                   F. "health care facility" means the following entities with revenues of at least five million dollars ($5,000,000) annually: a public hospital; a profit or nonprofit private hospital; a general or special hospital; a practice owned by, affiliated with or operating under the license of a hospital; a freestanding emergency facility or other outpatient clinic or facility; a crisis triage center; a freestanding birth center; an ambulance or air ambulance provider; an ambulatory surgical or urgent care center; a nursing home; an intermediate care facility; an assisted living facility; a diagnostic and treatment center; a rehabilitation center; an infirmary; a community mental health center that serves both children and adults or adults only; a residential treatment center; a day treatment center; a health service organization operating as a freestanding hospice or a home health agency; or facilities that must be licensed by the state to obtain or maintain full or partial, permanent or temporary federal funding;

                   G. "health care services" means services for the diagnosis, prevention, treatment, cure or relief of a physical, dental, behavioral or mental health condition, substance use disorder, illness, injury or disease, which services include procedures, products, devices or medications;

                   H. "household income" means income calculated by using the methods used to calculate medicaid eligibility;

                   I. "indigent patient" means a patient with a household income that does not exceed two hundred percent of the federal poverty level;

                   J. "medical creditor" means a person that provides health care services and to whom the consumer owes money for those services or the person that provided health care services and to whom the consumer previously owed money if the medical debt has been purchased by one or more medical debt buyers;

                   K. "medical debt" means a debt arising from the receipt of health care services;

                   L. "medical debt buyer" means a person that is engaged in the business of purchasing medical debts for collection purposes, whether that person collects the debt or hires a third party for collection or an attorney for litigation in order to collect such debt;

                   M. "medical debt collector" means a person that regularly collects or attempts to collect, directly or indirectly, medical debts originally owed or due or asserted to be owed or due to another person. A medical debt buyer is considered to be a medical debt collector for all purposes of the Patients' Debt Collection Protection Act;

                   N. "patient" means the person who received health care services or a parent or legal guardian of a minor or an adult under guardianship who received health care services;

                   O. "superintendent" means the superintendent of insurance; and

                   P. "third-party health care provider" means a licensed health care professional or an entity with revenues of at least five million dollars ($5,000,000) annually, when billing patients independently for health care services provided in a health care facility."

         SECTION 3. A new section of Chapter 57 NMSA 1978 is enacted to read:

         "[NEW MATERIAL] REQUIREMENT TO PROVIDE SCREENING FOR INSURANCE AND PROGRAM ELIGIBILITY.--

                   A. In addition to any other actions required by applicable state or federal law or local government ordinance, health care facilities shall take the following steps before seeking payment for emergency or medically necessary care:

                               (1) offer to and, if requested, verify whether a patient has any health insurance;

                               (2) if the patient is uninsured, offer information about, offer to screen the patient for and, if requested, screen the patient for:

                                         (a) all available public insurance;

                                         (b) any other public programs that may assist with health care costs; and

                                         (c) any financial assistance offered by the health care facility;

                               (3) offer to and, if requested, provide assistance with the application process for programs identified during the screening; and

                               (4) if a third-party health care provider will bill the patient, send the information gathered during the steps required pursuant to this subsection to the third-party health care provider.

                   B. In addition to any other actions required by applicable state or federal law or local government ordinance, a third-party health care provider shall not seek payment for emergency or medically necessary care until the third-party health care provider receives the information required pursuant to Paragraph (4) of Subsection A of this section.

                   C. The superintendent shall promulgate rules to establish minimum standards governing the requirements of this section and shall provide health care facilities and third-party health care providers with guidance on billing and screening best practices that includes policies to prevent the disclosure of patients' personal information to third parties."

         SECTION 4. A new section of Chapter 57 NMSA 1978 is enacted to read:

         "[NEW MATERIAL] INDIGENT PATIENTS--PATIENTS' DEBT COLLECTION PROTECTIONS.--

                   A. For patients who are determined to be indigent patients, charges for health care services and medical debt shall not be pursued through collection actions. All collection actions through which charges for health care services and medical debt are pursued shall be terminated upon the determination that a patient is an indigent patient. Health care facilities, third-party health care providers and medical creditors shall not hire or otherwise engage third parties to perform collection actions against or otherwise recover debts from indigent patients.

                   B. The superintendent shall promulgate rules to establish the process by which a patient is determined to be an indigent patient for purposes of this section."

         SECTION 5. A new section of Chapter 57 NMSA 1978 is enacted to read:

         "[NEW MATERIAL] DEPARTMENT GUIDANCE ON FUNDING SOURCES, BILLING AND SCREENING.--The department shall provide health care facilities and third-party health care providers with guidance on accessing available sources of funding for care that maximizes the use of funds in the following order of priority:

                   A. federal funds;

                     B. state funds; and

                   C. other available funds."

         SECTION 6. A new section of Chapter 57 NMSA 1978 is enacted to read:

         "[NEW MATERIAL] PRICE INFORMATION.--Health care facilities shall make available plain-language titles or descriptions of all health care services that can be understood by the average consumer and the relevant gross charge next to, as applicable, the amount that medicare would reimburse for all health care services. These health care facilities shall:

                   A. provide the information required in this section upon request for any health care service; and

                   B. post on the health care facility's website and make available via a link from the website's homepage the information required in this section for up to three hundred of the health care facility's most provided and billed health care services, including the seventy services specified by the federal centers for medicare and medicaid services that can be scheduled by a health care consumer in advance."

         SECTION 7. A new section of Chapter 57 NMSA 1978 is enacted to read:

         "[NEW MATERIAL] BILLING INFORMATION.--

                   A. All bills sent from a health care facility, third-party health care provider or medical creditor to a patient shall include a complete and plain-language description of the date, amount and nature of all charges; if the patient is verified as having health insurance; if the health care facility screened the patient for programs that assist with health care costs; and if the health care facility or third-party health care provider has billed or will bill insurance or public programs that may assist with health care costs for the services provided. Prior to initiating communication with a consumer or a collection action over medical debt, a medical debt collector shall have all billing information required in this subsection.

                   B. In all communications with a consumer about medical debt, including communication related to collection actions, a health care facility, third-party health care provider, medical creditor or medical debt collector shall inform the consumer of the availability of the information required pursuant to Subsection A of this section and offer to provide that information to the consumer."

         SECTION 8. A new section of Chapter 57 NMSA 1978 is enacted to read:

         "[NEW MATERIAL] RECEIPTS FOR PAYMENTS.--

                   A. Within thirty business days of receipt of a payment on a medical debt, the health care facility, third-party health care provider, medical creditor, medical debt collector or their agents receiving the payment shall send a receipt to the person who made the payment. The receipt may take the form of a billing statement. All receipts shall show:

                               (1) the amount paid;

                               (2) the date payment was received;

                               (3) the account's balance before the most recent payment;

                               (4) the