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SB2165
THE SENATE
S.B. NO.
2165
THIRTY-THIRD LEGISLATURE, 2026
STATE OF HAWAII
A BILL FOR AN ACT
relating
to medical debt
.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
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SECTION 1.
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This Act shall
be known as the "Medical Debt Protection and Patient Dignity Act".
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SECTION 2.
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The Hawaii Revised Statutes is amended by adding a new chapter to be
appropriately designated and to read as follows:
"
Chapter
PROHIBITED MEDICAL DEBT COLLECTION PRACTICES
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Definitions.
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As used in this chapter:
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"Health care provider" means any person,
corporation, facility, or institution licensed by the State to provide health
care services including but not limited to a hospital, clinic, physician,
physician group, or contractor providing medical services.
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"Medical creditor" means any
entity that provides health care services and to whom a patient owes money for
health care services, or the entity that provided health care services and to
whom the patient previously owed money if the medical debt has been purchased
by one or more debt buyers.
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"Medical debt" means any
obligation or alleged obligation arising from the receipt of medical care,
services, productions, or hospitalization, including charges from hospitals,
clinics, individual providers, and third-party contractors which includes
physical groups.
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"Non-emergency medically necessary
care" means health care services required to diagnose, prevent, or treat
an illness, injury, condition, disease, or the symptoms of a disease that are
not classified as emergency services under the federal Emergency Medical
Treatment and Labor Act or applicable state laws.
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"Patient" means an individual
receiving care or their legally responsible party.
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"Primary residence" means the
single property that serves as a patient's primary home.
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"Revenue threshold" means a
minimum of annual gross revenues of $20,000,000 or more, calculated on a
consolidated basis, including all subsidiaries and affiliates.
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"Very low-income" means a household
income that is less than or equal to five hundred per cent of the Federal
Poverty Level as determined by the poverty guidelines issued annually by the
United States Department of Health and Human Services.
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Medical debt collection; lawsuits; asset
seizure; wage garnishment; home liens; prohibited.
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No health care provider or medical creditor
shall:
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(1)
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File
or maintain a civil lawsuit to collect medical debt from a very low-income
patient or the patient's guarantor;
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(2)
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Seek,
obtain, or enforce wage garnishment, seizure or freezing of any bank account,
or levy or execute on any personal property in satisfaction of medical debt
against a patient or the patient's guarantor, regardless of income level; or
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(3)
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Place
or attempt to place a lien on the primary residence of a patient or the
patient's guarantor in relation to any medical debt.
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Sale of medical debt; prohibited.
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(a)
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No
health care provider or medical creditor shall sell, transfer, assign, or
otherwise convey any patient medical debt to a third party for collection or
profit.
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(b)
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Any sale or transfer conducted in violation of this section shall be
deemed null and void and the debt shall be considered legally uncollectible.
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Denial of non-emergency medically necessary
inpatient care; prohibition.
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(a)
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No health care provider whose
annual gross revenues exceed the revenue threshold shall deny non-emergency
medically necessary care to a patient based on the patient's:
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(1)
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Inability
to pay;
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(2)
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Outstanding
medical debt; or
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(3)
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Incomplete
payment history.
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(b)
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Regardless of a patient's income status or prior collection history, any
health care provider whose annual gross revenues exceed the revenue threshold
shall:
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(1)
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Offer
non-emergency medically necessary care to a patient; and
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(2)
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Develop
and publicly make available a clear financial assistance policy that ensures
screening for financial need and access to health care.
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Penalties.
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(a)
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Any violation of this
chapter shall be deemed an unfair or deceptive practice and shall be subject to
the provisions of chapter 480D.
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(b)
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A patient shall have a private right of action to obtain damages,
injunctive relief, and attorneys' fees for any violation of this chapter.
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(c)
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Any
violation of this chapter shall be subject to the enforcement authority of the
attorney general or the director of commerce and consumer affairs."
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SECTION 3.
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If any provision of this Act, or the application thereof to any person
or circumstance, is held invalid, the invalidity does not affect other
provisions or applications of the Act that can be given effect without the
invalid provision or application, and to this end the provisions of this Act
are severable.
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SECTION 4.
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This Act shall take effect on January 1, 2027.
INTRODUCED BY:
_____________________________
Report Title:
Department
of Commerce and Consumer Affairs; Medical Debt; Health Care Providers; Medical
Creditors; Debt Collection; Prohibition
Description:
Prohibits
a health care provider or medical creditor from filing a civil lawsuit to
collect medical debt from a patient whose household income is less than or
equal to five hundred percent of the Federal Poverty Level.
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Prohibits a health care provider or medical
creditor from engaging in certain debt collection practices.
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Prohibits a health care provider or medical
creditor from selling medical debt.
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Prohibits a health care provider whose income exceeds a certain
threshold from denying non-emergency medically necessary care to patients.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.