Title 23
Health and Safety

Chapter 17
Licensing of Healthcare Facilities

§ 23-17-67. Hospital determinations for Medicare and Medicaid for uninsured patients. [Effective January 1, 2025.]

(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 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-day (30) 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 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 section shall be posted, either by physical or electronic means, in accordance with § 23-17-54.

(3) 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.

(4) Within one hundred eighty (180) days after January 1, 2025, 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 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.