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<bill bill-stage="Introduced-in-Senate" dms-id="A1" public-private="public" slc-id="S1-BAI21112-TDG-8N-M0C"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
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<dc:title>117 S355 IS: COVID–19 Medical Debt Collection Relief Act of 2021</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2021-02-22</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">II</distribution-code><congress>117th CONGRESS</congress><session>1st Session</session><legis-num>S. 355</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20210222">February 22, 2021</action-date><action-desc><sponsor name-id="S390">Mr. Van Hollen</sponsor> (for himself, <cosponsor name-id="S322">Mr. Merkley</cosponsor>, <cosponsor name-id="S307">Mr. Brown</cosponsor>, and <cosponsor name-id="S341">Mr. Blumenthal</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSHR00">Committee on Health, Education, Labor, and Pensions</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>To provide immediate relief for patients from certain medical debt collection efforts during and immediately after the COVID–19 public health emergency. </official-title></form><legis-body display-enacting-clause="yes-display-enacting-clause"><section section-type="section-one" id="S1"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>COVID–19 Medical Debt Collection Relief Act of 2021</short-title></quote>.</text></section><section id="id5B272B7ED0014F86A9C1BBABBCD8110A"><enum>2.</enum><header>Relief from medical debt collection</header><subsection id="id0C5F850ABB654FA89979F112635975CB"><enum>(a)</enum><header>Definitions</header><text>In this section:</text><paragraph id="id51c526b170ac4c4aaf76288f51fa015b"><enum>(1)</enum><header>Covered period</header><text>The term <term>covered period</term> means the period beginning on February 1, 2020, and ending on the date that is the later of—</text><subparagraph id="idbd25bce4cb7d421c8e0cb7bd3a4b8600"><enum>(A)</enum><text>the end of the incident period with respect to the emergency involving Federal primary responsibility determined to exist by the President under section 501(b) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/42/5191">42 U.S.C. 5191(b)</external-xref>) with respect to the coronavirus disease 2019 (COVID–19); or</text></subparagraph><subparagraph id="idb9164e5a88be47799a9f0cb6f1eafdce"><enum>(B)</enum><text>18 months after the date of enactment of this Act. </text></subparagraph></paragraph><paragraph id="id452a3b3fb070423d93b0d8927b65b811"><enum>(2)</enum><header>Covered provider</header><text>The term <term>covered provider</term> means any entity or individual that—</text><subparagraph id="id0dc5e799c3864385b2b93b0d6fd26062"><enum>(A)</enum><text>provides health care services to patients; and</text></subparagraph><subparagraph id="id4c9a9e8579f741b3909f865d505b9d29"><enum>(B)</enum><text>has applied for or accepted any Federal funds for COVID–19 health care costs or financial relief, including funds allocated under the Families First Coronavirus Response Act (<external-xref legal-doc="public-law" parsable-cite="pl/116/127">Public Law 116–127</external-xref>), the CARES Act (<external-xref legal-doc="public-law" parsable-cite="pl/116/136">Public Law 116–136</external-xref>), or any other Federal law that allocates COVID–19 relief funding.</text></subparagraph></paragraph><paragraph id="ide26106182c9a4f3d8765916145367fdf"><enum>(3)</enum><header>Extraordinary collection actions</header><text>The term <term>extraordinary collection actions</term> means the actions described in section 1.501(r)–6(b) of title 26, Code of Federal Regulations.</text></paragraph><paragraph id="id8152B5FA519847898DCA6AB732E4E11B"><enum>(4)</enum><header>Medical debt</header><text>The term <term>medical debt</term> means a debt arising from the receipt of medical services, products, or devices.</text></paragraph><paragraph id="id4B6AC19FFC0844569CB23A03FFECE7FB"><enum>(5)</enum><header>Secretary</header><text>The term <term>Secretary</term> means the Secretary of Health and Human Services.</text></paragraph></subsection><subsection id="idBF8D506CC49940B08BAFA3548221BEB4"><enum>(b)</enum><header>Suspension of collection activities</header><text>A covered provider and agents operating on behalf of covered providers shall suspend all extraordinary collection actions relating to the collection of a medical debt relating to a patient during the covered period. </text></subsection><subsection id="id337db20694384851b0e42af0961e0550"><enum>(c)</enum><header>Suspension of repayment plans</header><paragraph id="id5B2D231A92174FFDB08024000EFF5718"><enum>(1)</enum><header>In general</header><text>With respect to a patient who has entered into a repayment plan with a covered provider relating to a medical debt, such provider shall take the following actions:</text><subparagraph id="idce12b259a23041e988456c4ee885a0ba"><enum>(A)</enum><text>Include in patient billing a notification that repayment plans for medical debt are available upon request.</text></subparagraph><subparagraph id="id152e992b6eb24984a1798a1712c56ead"><enum>(B)</enum><text>Include in patient billing a notification that any patient who has entered into a repayment plan with the provider may request a suspension of the payment plan during the covered period, and provide contact information for the patient to make such request. </text></subparagraph><subparagraph id="id222A8F06291C4769BF788F210197450A"><enum>(C)</enum><text>Suspend such repayment plan upon the request of the patient or the patient's guardian for the duration of the covered period. </text></subparagraph><subparagraph id="id1E0BEDD7C5E14A90B4F4C01186D98554"><enum>(D)</enum><text>Ensure the application of reasonable forbearance and repayment options when such repayments resume. Such options may include maintaining the same payment schedule with respect to the medical debt by extending the repayment period by the same period of time that payments were suspended under this subsection.</text></subparagraph></paragraph><paragraph id="ide27c2f75c1844f66bad468bbe8ed904a"><enum>(2)</enum><header>Guidance</header><text>Not later than 14 days after the date of enactment of this Act, the Secretary shall issue guidance on best practices for notifying patients of their repayment options, as described in paragraph (1). Such guidance shall include taglines that alert individuals with limited English proficiency (LEP) to the availability of language assistance services. </text></paragraph><paragraph id="idA983B0E630764487BC6C349FB409A74F"><enum>(3)</enum><header>Interest and fees</header><text>Interest or fees shall not accrue during the period in which a payment plan is suspended under paragraph (1). </text></paragraph></subsection><subsection id="id9D6718BCEC8B4D06BE42851242AB8CD6"><enum>(d)</enum><header>Application of certain consumer protections</header><paragraph id="id1379DECBD6714845A29E44BFB15DADA2"><enum>(1)</enum><header>In general</header><text>Medical debt incurred during the period beginning on February 1, 2020, and ending on the date that is 60 days after the lifting of the state of emergency for COVID–19-related testing and treatment (as determined by the Secretary) shall be subject to the following consumer protections:</text><subparagraph id="id50f5f616812d4372b4df94f8af8d316a"><enum>(A)</enum><text>A one-year extension of Federal and State health insurance appeal deadlines, including the deadlines set forth in section 2719 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300gg-19">42 U.S.C. 300gg–19</external-xref>) and sections 2590.715 through 2179 of title 29, Code of Federal Regulations, and the appeal and grievance deadlines for the denials of Medicare or Medicaid claims under titles XVIII and XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395</external-xref> and 1396 et seq.).</text></subparagraph><subparagraph id="idadd2f97ce9ac467d96c0b3b754d8e610"><enum>(B)</enum><text>A prohibition on the accrual and collection of fees and interest related to the medical debts involved.</text></subparagraph><subparagraph id="id201c79704bb24172b5329ec534acbb0d"><enum>(C)</enum><text>A prohibition on any extraordinary collection actions as described in sections 1.501(r)–(6)(b) of title 26, Code of Federal Regulations. </text></subparagraph></paragraph><paragraph id="ida4aaf3011b3d4da7a4eee67eaa35c125"><enum>(2)</enum><header>COVID–19 related testing and treatment</header><text>For purposes of paragraph (1), the term <term>COVID–19-related testing and treatment</term> includes items and services (including in-person or telehealth visits in which such items and services are furnished) that are furnished—</text><subparagraph id="id2787f1868e974378a741561a214b2b17"><enum>(A)</enum><text>to an individual who has been diagnosed with (or after the provision of such items and services is diagnosed with) COVID–19 to treat or mitigate the effects of COVID–19; and</text></subparagraph><subparagraph id="idd159147df90047df9d3ab28e6476bb79"><enum>(B)</enum><text>to an individual who is presumed by a health care provider to have COVID–19 but is never diagnosed as such.</text></subparagraph></paragraph></subsection><subsection id="id3637D2B3E9154333B7052727A36F76A2"><enum>(e)</enum><header>Penalties</header><text>Except as provided in this section, a covered provider or its agent that fails to comply with any provision of this section with respect to a patient shall be liable to such patient for damages in an amount equal to the sum of—</text><paragraph id="id1a7890712c9c46af8b51e88250ead2c4"><enum>(1)</enum><text>any actual damages sustained by such patient as a result of such failure to comply;</text></paragraph><paragraph id="ide7b094436f254368955c86faeef13ed5"><enum>(2)</enum><text>in the case of an action commenced—</text><subparagraph id="id5DE0DE87E0B1456E84C424C9D620AB92"><enum>(A)</enum><text>by an individual, any additional damages as the court may permit, but not to exceed $1,000 for each failure to comply; or</text></subparagraph><subparagraph id="id9b861b40ea5c4040b94348dd559dbe75"><enum>(B)</enum><text>by a class of patients—</text><clause id="idAF1BE110A26F4194847ABF6E177DB152"><enum>(i)</enum><text>such amount for each named plaintiff as could be recovered under paragraph (1) and subparagraph (A); and</text></clause><clause id="idE83EBD3C462A4D5CABBF7713DE4C70DF"><enum>(ii)</enum><text>such amount as the court may allow for all other class members, without regard to a minimum individual recovery, not to exceed the lesser of $2,000,000 or 1 percent of the annual net income of the covered provider; and</text></clause></subparagraph></paragraph><paragraph id="idc752726f1e3d45769008da563edcdde3"><enum>(3)</enum><text>in the case of any successful action under this section, the costs of the action, together with a reasonable attorney’s fee as determined appropriate by the court. </text></paragraph></subsection></section></legis-body></bill> 

