2024 -- S 2714

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LC004260

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2024

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A N   A C T

RELATING TO HEALTH AND SAFETY -- LICENSING OF HEALTHCARE FACILITIES

     Introduced By: Senators Lauria, Miller, DiMario, Lawson, Pearson, Valverde, Ujifusa,
LaMountain, Murray, and Cano

     Date Introduced: March 05, 2024

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Chapter 23-17 of the General Laws entitled "Licensing of Healthcare

Facilities" is hereby amended by adding thereto the following section:

     23-17-67. Hospital determinations for Medicare and Medicaid for uninsured patients.

     (a) All hospitals shall screen each uninsured patient, upon the uninsured patient's

agreement, at the earliest reasonable moment for potential eligibility for both:

     (1) Public health insurance programs; and

     (2) Any financial assistance offered by the hospital.

     (b) All screening activities, including initial screenings and all follow-up assistance, shall

be provided in compliance with § 23-17-54.

     (c) If a patient declines or fails to respond to the screening described in subsection (a) of

this section, the hospital shall document in the patient's record the patient's decision to decline or

failure to respond to the screening, confirming the date and method by which the patient declined

or failed to respond.

     (d) If a patient does not decline the screening described in subsection (a) of this section, a

hospital should screen an uninsured patient during registration unless it would cause a delay of care

to the patient; otherwise, a hospital shall screen an uninsured patient at the earliest reasonable

moment.

     (e) If a patient does not submit to screening, financial assistance application, or reasonable

payment plan documentation within thirty (30) days after a request, the hospital shall document the

lack of received documentation, confirming the date that the screening took place and that the thirty

(30) day timeline for responding to the hospital's request has lapsed; provided, however, that it may

be reopened within ninety (90) days after the date of discharge, date of service, or completion of

the screening.

     (f) If the screening indicates that the patient may be eligible for a public health insurance

program, the hospital shall provide information to the patient about how the patient can apply for

the public health insurance program, including, but not limited to, referral to healthcare navigators

who provide free and unbiased eligibility and enrollment assistance, including healthcare

navigators at federally qualified health centers; local, state, or federal government agencies; or any

other resources that the state recognizes as designed to assist uninsured individuals in obtaining

health coverage.

     (g) If the uninsured patient's application for a public health insurance program is approved,

the hospital shall bill the insuring entity and shall not pursue the patient for any aspect of the bill,

except for any required copayment, coinsurance, or other similar payment for which the patient is

responsible under the insurance. If the uninsured patient's application for public health insurance is

denied, the hospital shall again offer to screen the uninsured patient for hospital financial assistance,

and the timeline for applying for financial assistance under the this section shall begin again.

     (h) A hospital shall offer to screen an insured patient for hospital financial assistance under

this section if the patient requests financial assistance screening, if the hospital is contacted in

response to a bill, if the hospital learns information that suggests an inability to pay, or if the

circumstances otherwise suggest the patient's inability to pay.

     (i)(1) Each hospital shall post a sign with the following notice: "You may be eligible for

financial assistance under the terms and conditions the hospital offers to qualified patients. For

more information contact [hospital financial assistance representative]".

     (2) The sign under subsection (i)(1) of this subsection shall be posted, either by physical

or electronic means, conspicuously in the admission and registration areas of the hospital.

     (3) The sign shall be in English, and in any other language that is the primary language of

at least five percent (5%) of the patients served by the hospital annually.

     (4) Each hospital that has a website shall post a notice in a prominent place on its website

that financial assistance is available at the hospital, a description of the financial assistance

application process, and a copy of the financial assistance application.

     (5) Within one hundred eighty (180) days after the effective date of this section, each

hospital shall make available information regarding financial assistance from the hospital in the

form of either a brochure, an application for financial assistance, or other written or electronic

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material in the emergency room, hospital admission, and registration area.

     (j)(1) The executive office of health and human services is responsible for administering

and ensuring compliance with this section, including the development of any rules and regulations

necessary for the implementation and enforcement of this section.

     (2) The executive office of health and human services shall develop and implement a

process for receiving and handling complaints from individuals or hospitals regarding possible

violations of this section.

     (3) The attorney general may conduct any investigation deemed necessary regarding

possible violations of this section by any hospital including, without limitation, the issuance of

subpoenas to:

     (i) Require the hospital to file a statement or report or answer interrogatories in writing as

to all information relevant to the alleged violations;

     (ii) Examine under oath any person who possesses knowledge or information directly

related to the alleged violations; and

     (iii) Examine any record, book, document, account, or paper necessary to investigate the

alleged violation.

     (4) If the attorney general determines that there is a reason to believe that any hospital has

violated this section, the attorney general may bring an action against the hospital to obtain

temporary, preliminary, or permanent injunctive relief for any act, policy, or practice by the hospital

that violates this section. Before bringing such an action, the attorney general may permit the

hospital to submit a correction plan for the attorney general's approval.

     SECTION 2. This act shall take effect on January 1, 2025.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY -- LICENSING OF HEALTHCARE FACILITIES

***

     This act would require all hospitals to screen uninsured patients for eligibility for public

health programs and financial assistance under Medicare and Medicaid.

     This act would take effect on January 1, 2025.

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