COVID–19 Medical Debt Collection Relief Act of 2021

II 117TH CONGRESS 1ST SESSION S. 355 To provide immediate relief for patients from certain medical debt collection efforts during and immediately after the COVID–19 public health emergency. IN THE SENATE OF THE UNITED STATES FEBRUARY 22, 2021 Mr. VAN HOLLEN (for himself, Mr. MERKLEY, Mr. BROWN, and Mr. BLUMENTHAL) introduced the following bill; which was read twice and re- ferred to the Committee on Health, Education, Labor, and Pensions A BILL To provide immediate relief for patients from certain medical debt collection efforts during and immediately after the COVID–19 public health emergency. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘COVID–19 Medical 4 Debt Collection Relief Act of 2021’’. 5 SEC. 2. RELIEF FROM MEDICAL DEBT COLLECTION. 6 (a) DEFINITIONS.—In this section: 7 VerDate Sep 11 2014 16:05 Feb 28, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S355.IS S355 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 355 IS (1) COVERED PERIOD.—The term ‘‘covered pe- 1 riod’’ means the period beginning on February 1, 2 2020, and ending on the date that is the later of— 3 (A) the end of the incident period with re- 4 spect to the emergency involving Federal pri- 5 mary responsibility determined to exist by the 6 President under section 501(b) of the Robert T. 7 Stafford Disaster Relief and Emergency Assist- 8 ance Act (42 U.S.C. 5191(b)) with respect to 9 the coronavirus disease 2019 (COVID–19); or 10 (B) 18 months after the date of enactment 11 of this Act. 12 (2) COVERED PROVIDER.—The term ‘‘covered 13 provider’’ means any entity or individual that— 14 (A) provides health care services to pa- 15 tients; and 16 (B) has applied for or accepted any Fed- 17 eral funds for COVID–19 health care costs or 18 financial relief, including funds allocated under 19 the Families First Coronavirus Response Act 20 (Public Law 116–127), the CARES Act (Public 21 Law 116–136), or any other Federal law that 22 allocates COVID–19 relief funding. 23 (3) EXTRAORDINARY COLLECTION ACTIONS.— 24 The term ‘‘extraordinary collection actions’’ means 25 VerDate Sep 11 2014 16:05 Feb 28, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S355.IS S355 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 355 IS the actions described in section 1.501(r)–6(b) of title 1 26, Code of Federal Regulations. 2 (4) MEDICAL DEBT.—The term ‘‘medical debt’’ 3 means a debt arising from the receipt of medical 4 services, products, or devices. 5 (5) SECRETARY.—The term ‘‘Secretary’’ means 6 the Secretary of Health and Human Services. 7 (b) SUSPENSION OF COLLECTION ACTIVITIES.—A 8 covered provider and agents operating on behalf of covered 9 providers shall suspend all extraordinary collection actions 10 relating to the collection of a medical debt relating to a 11 patient during the covered period. 12 (c) SUSPENSION OF REPAYMENT PLANS.— 13 (1) IN GENERAL.—With respect to a patient 14 who has entered into a repayment plan with a cov- 15 ered provider relating to a medical debt, such pro- 16 vider shall take the following actions: 17 (A) Include in patient billing a notification 18 that repayment plans for medical debt are 19 available upon request. 20 (B) Include in patient billing a notification 21 that any patient who has entered into a repay- 22 ment plan with the provider may request a sus- 23 pension of the payment plan during the covered 24 VerDate Sep 11 2014 16:05 Feb 28, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S355.IS S355 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 355 IS period, and provide contact information for the 1 patient to make such request. 2 (C) Suspend such repayment plan upon 3 the request of the patient or the patient’s 4 guardian for the duration of the covered period. 5 (D) Ensure the application of reasonable 6 forbearance and repayment options when such 7 repayments resume. Such options may include 8 maintaining the same payment schedule with 9 respect to the medical debt by extending the re- 10 payment period by the same period of time that 11 payments were suspended under this sub- 12 section. 13 (2) GUIDANCE.—Not later than 14 days after 14 the date of enactment of this Act, the Secretary 15 shall issue guidance on best practices for notifying 16 patients of their repayment options, as described in 17 paragraph (1). Such guidance shall include taglines 18 that alert individuals with limited English pro- 19 ficiency (LEP) to the availability of language assist- 20 ance services. 21 (3) INTEREST AND FEES.—Interest or fees 22 shall not accrue during the period in which a pay- 23 ment plan is suspended under paragraph (1). 24 VerDate Sep 11 2014 16:05 Feb 28, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S355.IS S355 pamtmann on DSKBC07HB2PROD with BILLS 5 •S 355 IS (d) APPLICATION OF CERTAIN CONSUMER PROTEC- 1 TIONS.— 2 (1) IN GENERAL.—Medical debt incurred dur- 3 ing the period beginning on February 1, 2020, and 4 ending on the date that is 60 days after the lifting 5 of the state of emergency for COVID–19-related 6 testing and treatment (as determined by the Sec- 7 retary) shall be subject to the following consumer 8 protections: 9 (A) A one-year extension of Federal and 10 State health insurance appeal deadlines, includ- 11 ing the deadlines set forth in section 2719 of 12 the Public Health Service Act (42 U.S.C. 13 300gg–19) and sections 2590.715 through 14 2179 of title 29, Code of Federal Regulations, 15 and the appeal and grievance deadlines for the 16 denials of Medicare or Medicaid claims under 17 titles XVIII and XIX of the Social Security Act 18 (42 U.S.C. 1395 and 1396 et seq.). 19 (B) A prohibition on the accrual and col- 20 lection of fees and interest related to the med- 21 ical debts involved. 22 (C) A prohibition on any extraordinary col- 23 lection actions as described in sections 24 VerDate Sep 11 2014 16:05 Feb 28, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S355.IS S355 pamtmann on DSKBC07HB2PROD with BILLS 6 •S 355 IS 1.501(r)–(6)(b) of title 26, Code of Federal 1 Regulations. 2 (2) COVID–19 RELATED TESTING AND TREAT- 3 MENT.—For purposes of paragraph (1), the term 4 ‘‘COVID–19-related testing and treatment’’ includes 5 items and services (including in-person or telehealth 6 visits in which such items and services are fur- 7 nished) that are furnished— 8 (A) to an individual who has been diag- 9 nosed with (or after the provision of such items 10 and services is diagnosed with) COVID–19 to 11 treat or mitigate the effects of COVID–19; and 12 (B) to an individual who is presumed by a 13 health care provider to have COVID–19 but is 14 never diagnosed as such. 15 (e) PENALTIES.—Except as provided in this section, 16 a covered provider or its agent that fails to comply with 17 any provision of this section with respect to a patient shall 18 be liable to such patient for damages in an amount equal 19 to the sum of— 20 (1) any actual damages sustained by such pa- 21 tient as a result of such failure to comply; 22 (2) in the case of an action commenced— 23 VerDate Sep 11 2014 16:05 Feb 28, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S355.IS S355 pamtmann on DSKBC07HB2PROD with BILLS 7 •S 355 IS (A) by an individual, any additional dam- 1 ages as the court may permit, but not to exceed 2 $1,000 for each failure to comply; or 3 (B) by a class of patients— 4 (i) such amount for each named plain- 5 tiff as could be recovered under paragraph 6 (1) and subparagraph (A); and 7 (ii) such amount as the court may 8 allow for all other class members, without 9 regard to a minimum individual recovery, 10 not to exceed the lesser of $2,000,000 or 11 1 percent of the annual net income of the 12 covered provider; and 13 (3) in the case of any successful action under 14 this section, the costs of the action, together with a 15 reasonable attorney’s fee as determined appropriate 16 by the court. 17 Æ VerDate Sep 11 2014 16:05 Feb 28, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\S355.IS S355 pamtmann on DSKBC07HB2PROD with BILLS