Vermont § 9482 - Financial assistance policies for large health care facilities

§ 9482. Financial assistance policies for large health care facilities

• (a) Each large health care facility in this State shall develop a written financial assistance
  policy that, at a minimum, complies with the provisions of this subchapter and any
  applicable federal requirements. (b) The financial assistance policy shall: (1) apply, at a minimum, to all emergency and other medically necessary health care services
  that the large health care facility offers; (2) provide free or discounted care to Vermont residents and to individuals who live in
  Vermont at the time the services are delivered but who lack stable permanent housing,
  as follows: (A) for an uninsured patient with household income at or below 250 percent of the federal
  poverty level (FPL), a 100 percent discount from the amount generally billed for the
  services received, resulting in free care; (B) for an uninsured patient with household income between 250 and 400 percent FPL, a
  minimum of a 40 percent discount from the amount generally billed for the services
  received; (C) for a patient with health insurance or other coverage for the services delivered and
  with household income at or below 250 percent FPL, a waiver of all out-of-pocket costs
  that would otherwise be due from the patient; (D) for a patient with health insurance or other coverage for the services delivered and
  with household income between 250 and 400 percent FPL, a minimum of a 40 percent discount
  on the patient’s out-of-pocket costs; and (E) for patients with household income at or below 600 percent FPL, catastrophic assistance
  in the event that the large health care facility’s medical bills for a patient’s care
  exceed 20 percent of the patient’s household income, in which case the facility shall
  reduce the amount due from the patient to 20 percent of the patient’s household income;
  and (3) include all of the following: (A) the eligibility criteria for financial assistance; (B) the basis for calculating amounts charged to patients; (C) the method and process for applying for financial assistance, including the information
  and documentation that the facility may require a patient to provide as part of the
  application; (D) the reasonable steps that the facility will take to determine whether a patient is
  eligible for financial assistance; (E) the facility’s billing and collections policy, including the actions the facility
  may take in the event of nonpayment, such as collections action and reporting to credit
  reporting agencies; (F) an appeals process for patients who are denied financial assistance or who believe
  the amount of financial assistance granted is inconsistent with the policy or the
  provisions of this subchapter; and (G) a plain language summary of the policy. (c) The owners or governing body of the large health care facility shall approve the facility’s
  financial assistance policy and shall review and approve the policy at least once
  every three years. (d) A large health care facility may require a patient to be a Vermont resident as a condition
  of eligibility for financial assistance but shall not impose any requirements regarding
  the duration of a patient’s status as a Vermont resident. (Added 2021, No. 119 (Adj. Sess.), § 1, eff. July 1, 2022.)