Virginia Law

A. As used in this section, "patient" and "uninsured patient" have the same meanings as ascribed to these terms in § 32.1-137.010 A of the Code of Virginia.

B. A general hospital shall make reasonable efforts to screen every uninsured patient to determine whether the individual is eligible for medical assistance pursuant to the state plan for medical assistance or for financial assistance under the general hospital's financial assistance policy.

C. A general hospital shall inform every uninsured patient who receives services at the general hospital and who is determined to be eligible for assistance under the general hospital's financial assistance policy of the option to enter into a payment plan with the general hospital.

1. A payment plan entered into pursuant to this subsection shall be provided to the patient in writing or electronically and shall provide for repayment of the cumulative amount owed to the general hospital.

2. The amount of monthly payments and the term of the payment plan shall be determined based upon the patient's ability to pay.

3. Any interest on amounts owed pursuant to the payment plan shall not exceed the maximum judgment rate of interest pursuant to § 6.2-302 of the Code of Virginia.

4. The general hospital may not charge any fees related to the payment plan.

5. The payment plan shall allow prepayment of amounts owed without penalty.

D. A general hospital shall develop a process by which either an uninsured patient who agrees to a payment plan pursuant to subsection C of this section or the general hospital may request and shall be granted the opportunity to renegotiate the payment plan.

1. Renegotiation shall include opportunity for a new screening in accordance with subsection B of this section.

2. A general hospital may not charge any fees for renegotiation of a payment plan pursuant to this subsection.

E. A general hospital shall provide written information about:

1. The general hospital's charity care policies, including:

a. Policies related to free and discounted care;

b. Specific eligibility criteria for charity care; and

c. Procedures for applying for charity care;

2. The availability of a payment plan for the payment of debt owed to the general hospital pursuant to subsection C of this section; and

3. The renegotiation process described in subsection D of this section.

F. To provide the information required by subsection E of this section, a general hospital shall:

1. Post the information conspicuously in public areas of the general hospital, including admissions or registration areas, emergency departments, and associated waiting rooms;

2. Make the information available to:

a. A patient at the time of admission or discharge, or at the time services are provided; and

b. Persons with limited English proficiency in accordance with the U.S. Department of Health and Human Services Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons (August 8, 2003, 68 FR 47311), if the general hospital is subject to the requirements of Title VI of the Civil Rights Act of 1964 (Pub. L. No. 88-352), as amended; and

3. Include the information:

a. With any billing statements sent to uninsured patients; and

b. On any website maintained by the general hospital.

G. Notwithstanding any other provision of law, a general hospital may not engage in any action described in § 501(r)(6) of the Internal Revenue Code as it was in effect on January 1, 2020, to recover a debt for medical services against any patient unless the general hospital has made all reasonable efforts to determine whether the patient:

1. Qualifies for medical assistance pursuant to the state plan for medical assistance; or

2. Is eligible for financial assistance under the general hospital's financial assistance policy.

H. Nothing in this section shall be construed to:

1. Prohibit a general hospital, as part of its financial assistance policy, from requiring a patient to:

a. Provide necessary information needed to determine eligibility for financial assistance under the general hospital's financial assistance policy, medical assistance pursuant to Title XVIII or XIX of the Social Security Act (42 USC § 301 et seq.), 10 USC § 1071 et seq., or other programs of insurance; or

b. Undertake good faith efforts to apply for and enroll in the programs of insurance for which the patient may be eligible as a condition of awarding financial assistance;

2. Require a general hospital to grant or continue to grant any financial assistance or payment plan pursuant to this section when:

a. A patient has provided false, inaccurate, or incomplete information required for determining eligibility for the general hospital's financial assistance policy; or

b. A patient has not undertaken good faith efforts to comply with any payment plan pursuant to this section; or

3. Prohibit the coordination of benefits as required by state or federal law.