STATE OF NEW YORK ________________________________________________________________________ 1753 2021-2022 Regular Sessions IN ASSEMBLY January 11, 2021 ___________ Introduced by M. of A. GOTTFRIED, ENGLEBRIGHT, SEAWRIGHT -- read once and referred to the Committee on Judiciary AN ACT to amend the public health law, the debtor and creditor law, the civil practice law and rules and the insurance law, in relation to COVID-19 pandemic medical debt requirements The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The public health law is amended by adding a new section 2 2828 to read as follows: 3 § 2828. COVID-19 pandemic medical debt requirements. 1. Definitions. 4 The following words or phrases, as used in this section, shall have the 5 following meanings: 6 (a) "Collection action" means any of the following: 7 (i) Selling an individual's debt to another party, except if, prior to 8 the sale, the medical creditor has entered into a legally binding writ- 9 ten agreement with the medical debt buyer of the debt pursuant to which: 10 (1) The medical debt buyer or collector is prohibited from engaging in 11 any collection actions, as defined herein, to obtain payment for the 12 care; 13 (2) The medical debt buyer is prohibited from charging interest on the 14 debt in excess of that described in subdivision three of this section; 15 (3) The debt is returnable to or recallable by the medical creditor 16 upon a determination by the medical creditor or medical debt buyer that 17 the individual is eligible for financial assistance; and 18 (4) If the individual is determined to be eligible for financial 19 assistance and the debt is not returned to or recalled by the medical 20 creditor, the medical debt buyer is required to adhere to procedures 21 which shall be specified in the agreement that ensure that the individ- 22 ual does not pay, and has no obligation to pay, the medical debt buyer 23 and the medical creditor together more than he or she is personally 24 responsible for paying in compliance with this section. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD00589-01-1A. 1753 2 1 (ii) Reporting adverse information about a patient to a consumer 2 reporting agency; or 3 (iii) Actions that require a legal or judicial process, including but 4 not limited to: 5 (1) Placing or executing a lien on the individual's property; 6 (2) Attaching or seizing an individual's bank account or any other 7 personal property; 8 (3) Commencing or prosecuting a civil action against an individual; 9 (4) Garnishing an individual's wages; or 10 (5) Any other involuntary collection activity. 11 (b) "Consumer reporting agency" has the same meaning as such term is 12 defined in section three hundred eighty-a of the general business law. 13 (c) "Declared state disaster emergency" means the declaration of a 14 state of emergency pursuant to article two-B of the executive law. 15 (d) "Healthcare professional" means a person licensed or certified 16 pursuant to title eight of the education law. 17 (e) "Healthcare services" means services for the diagnosis, 18 prevention, treatment, cure or relief of a physical, dental, behavioral 19 substance use disorder or mental health condition, illness, injury or 20 disease. These services include, but are not limited to, any procedures, 21 products, devices or medications. 22 (f) "Hospital" means all providers licensed under this article. 23 (g) "Medical debt" means a debt arising from the receipt of healthcare 24 services. 25 (h) "Medical debt buyer" means a person or entity that is engaged in 26 the business of purchasing medical debts for collection purposes, wheth- 27 er it collects the debt itself or hires a third party for collection or 28 an attorney for litigation in order to collect such debt. 29 (i) "Medical debt collector" means any person or entity that regularly 30 collects or attempts to collect, directly or indirectly, medical debts 31 originally owed or due or asserted to be owed or due to another. A 32 medical debt buyer is considered to be a medical debt collector for all 33 purposes. 34 (j) "Patient" means the person who received healthcare services, and 35 for the purposes of this section shall include: a parent if the patient 36 is a minor; a legal guardian if the patient is an adult under guardian- 37 ship; an authorized representative; or a guarantor. 38 (k) "Period of suspension" means a period consisting of the first day 39 of a declared state disaster emergency related to the COVID-19 pandemic 40 and until no less than sixty days after a declared state disaster emer- 41 gency related to the COVID-19 pandemic is no longer in effect anywhere 42 in the state. 43 2. Involuntary collection activity. No hospital or healthcare profes- 44 sional shall engage in any collection actions during the period of 45 suspension. 46 3. No accrual of interest. Interest shall not accrue on any medical 47 debt described under subdivision two for which collection was suspended 48 for the period of suspension. 49 4. Notice. To inform patients of the actions taken in accordance with 50 this section and ensure an effective transition, all hospitals and 51 healthcare professionals shall: 52 (a) Not later than fifteen days after the effective date of this 53 section, notify patients: 54 (i) of the actions taken in accordance with subdivisions two and three 55 of this section for whom collections have been suspended and interest 56 waived;A. 1753 3 1 (ii) of the option to continue making payments toward any amount due; 2 and 3 (iii) that the program described in this section is a temporary 4 program. 5 (b) Within fifteen days after the expiration of the period of suspen- 6 sion, carry out a program to provide no fewer than three notices by 7 postal mail, telephone or electronic communication to patients indicat- 8 ing: 9 (i) when the patient's normal payment obligations will resume; 10 (ii) with respect to notices submitted by hospitals, that the patient 11 may be eligible to enroll in the hospital's financial assistance plan 12 pursuant to section twenty-eight hundred seven-k of this article; and 13 (iii) with respect to notices submitted by healthcare professionals, 14 that the patient may be eligible to enroll in a financial assistance 15 plan, if the healthcare professional has a financial assistance policy 16 for his or her patients. 17 5. Proof of submission of claim. With respect to patients who are 18 uninsured on the date that the treating hospital or healthcare profes- 19 sional renders testing or treatment services related to COVID-19, 20 including, but not limited to, diagnostic evaluations, testing or other 21 methods to rule out diseases with similar symptoms to COVID-19, no 22 hospital or healthcare professional may engage in any collection actions 23 to collect payment for such services, unless the treating hospital or 24 healthcare professional produces a sworn affidavit that he, she or it 25 submitted a claim for payment for such services to the federal depart- 26 ment of health and human services, health resources and services admin- 27 istration (HRSA), in accordance with federal law, and that HRSA denied 28 the claim. 29 6. Private right of action. Every violation of this section shall be 30 deemed a deceptive act and practice subject to enforcement under article 31 twenty-two-A of the general business law. Nothing in this section shall 32 be construed to restrict any right which any person may have under any 33 other statute or the common law. 34 § 2. The debtor and creditor law is amended by adding a new article 35 10-B to read as follows: 36 ARTICLE 10-B 37 TEMPORARY RELIEF FROM COLLECTION OF MEDICAL DEBT DURING THE 38 COVID-19 PANDEMIC 39 Section 286. Definitions. 40 287. Requirements. 41 § 286. Definitions. As used in this article, the following terms shall 42 have the following meanings: 43 1. "Collection action" means any of the following: 44 (a) Selling an individual's debt to another party, except if, prior to 45 the sale, the medical creditor has entered into a legally binding writ- 46 ten agreement with the medical debt buyer of the debt pursuant to which: 47 (i) The medical debt buyer or collector is prohibited from engaging in 48 any collection actions, as defined herein, to obtain payment for the 49 care; 50 (ii) The medical debt buyer is prohibited from charging interest on 51 the debt in excess of that described in this section; 52 (iii) The debt is returnable to or recallable by the medical creditor 53 upon a determination by the medical creditor or medical debt buyer that 54 the individual is eligible for financial assistance; and 55 (iv) If the individual is determined to be eligible for financial 56 assistance and the debt is not returned to or recalled by the medicalA. 1753 4 1 creditor, the medical debt buyer is required to adhere to procedures 2 which shall be specified in the agreement that ensure that the individ- 3 ual does not pay, and has no obligation to pay, the medical debt buyer 4 and the medical creditor together more than he or she is personally 5 responsible for paying in compliance with this section. 6 (b) Reporting adverse information about a patient to a consumer 7 reporting agency; or 8 (c) Actions that require a legal or judicial process, including but 9 not limited to: 10 (i) Placing or executing a lien on the individual's property; 11 (ii) Attaching or seizing an individual's bank account or any other 12 personal property; 13 (iii) Commencing or prosecuting a civil action against an individual; 14 (iv) Garnishing an individual's wages; or 15 (v) Any other involuntary collection activity. 16 2. "Consumer reporting agency" has the same meaning as such term is 17 defined in section three hundred eighty-a of the general business law. 18 3. "Declared state disaster emergency" means the declaration of a 19 state of emergency pursuant to article two-B of the executive law. 20 4. "Healthcare professional" means a person licensed or certified 21 pursuant to title eight of the education law. 22 5. "Healthcare services" means services for the diagnosis, prevention, 23 treatment, cure or relief of a physical, dental, behavioral substance 24 use disorder or mental health condition, illness, injury or disease. 25 These services include, but are not limited to, any procedures, 26 products, devices or medications. 27 6. "Hospital" means all hospitals licensed under article twenty-eight 28 of the public health law. 29 7. "Medical debt" means a debt arising from the receipt of healthcare 30 services. 31 8. "Medical debt buyer" means a person or entity that is engaged in 32 the business of purchasing medical debts for collection purposes, wheth- 33 er it collects the debt itself or hires a third party for collection or 34 an attorney for litigation in order to collect such debt. 35 9. "Medical debt collector" means any person or entity that regularly 36 collects or attempts to collect, directly or indirectly, medical debts 37 originally owed or due or asserted to be owed or due to another. A 38 medical debt buyer is considered to be a medical debt collector for all 39 purposes. 40 10. "Patient" means the person who received healthcare services, and 41 for the purposes of this article shall include: a parent if the patient 42 is a minor; a legal guardian if the patient is an adult under guardian- 43 ship; an authorized representative; or a guarantor. 44 11. "Period of suspension" means a period consisting of the first day 45 of a declared state disaster emergency related to the COVID-19 pandemic 46 and until no less than sixty days after a declared state disaster emer- 47 gency related to the COVID-19 pandemic is no longer in effect anywhere 48 in the state. 49 § 287. Requirements. 1. Temporary relief from collection of medical 50 debt. All medical debt buyers and collectors shall suspend all payments 51 due for medical debt through the period of suspension. 52 2. No accrual of interest. Interest shall not accrue on any medical 53 debt described under subdivision one of this section for which payment 54 was suspended for the period of suspension. 55 3. Involuntary collection activity. No medical debt buyer or collector 56 shall engage in any collection actions during the period of suspension.A. 1753 5 1 4. Notice. To inform patients of the actions taken in accordance with 2 this section and ensure an effective transition, all medical debt buyers 3 and collectors shall: 4 (a) Not later than fifteen days after the effective date of this 5 section, notify patients: 6 (i) of the actions taken in accordance with subdivisions one and two 7 of this section for whom payments have been suspended and interest 8 waived; 9 (ii) of the actions taken in accordance with subdivision three of this 10 section for whom collections have been suspended; 11 (iii) of the option to continue making payments toward any amount due; 12 and 13 (iv) that the program described under this section is a temporary 14 program. 15 (b) Within fifteen days after the expiration of the period of suspen- 16 sion, carry out a program to provide no fewer than three notices by 17 postal mail, telephone or electronic communication to patients indicat- 18 ing: 19 (i) when the patient's normal payment obligations will resume; and 20 (ii) that the patient may be eligible to enroll in a financial assist- 21 ance plan pursuant to any applicable and available financial assistance 22 policy of either the medical debt buyer or collector. 23 5. Proof of submission of claim. With respect to patients who are 24 uninsured on the date that the treating hospital or healthcare profes- 25 sional renders testing or treatment services related to COVID-19, 26 including, but not limited to, diagnostic evaluations, testing or other 27 methods to rule out diseases with similar symptoms to COVID-19, no 28 medical debt buyer or collector may engage in any collection actions to 29 collect payment for such services, unless the treating hospital or 30 healthcare professional produces a sworn affidavit that he, she or it 31 submitted a claim for payment for such services to the federal depart- 32 ment of health and human services, health resources and services admin- 33 istration (HRSA), in accordance with federal law, and that HRSA denied 34 the claim. 35 6. Private right of action. Every violation of this section shall be 36 deemed a deceptive act and practice subject to enforcement under article 37 twenty-two-A of the general business law. Nothing in this section shall 38 be construed to restrict any right which any person may have under any 39 other statute or the common law. 40 § 3. Section 5004 of the civil practice law and rules, as amended by 41 chapter 258 of the laws of 1981, is amended to read as follows: 42 § 5004. Rate of interest. Interest shall be at the rate of nine per 43 centum per annum, except where otherwise provided by statute, provided 44 that the annual rate of interest to be paid on a judgment or accrued 45 claim in an action arising from a medical debt, as defined by section 46 two thousand eight hundred twenty-eight of the public health law, where 47 the purchaser, borrower or debtor is the defendant shall be calculated 48 at the one-year United States treasury bill rate; and provided further 49 that no interest shall accrue on a judgment or accrued claim in an 50 action arising from a medical debt while the state disaster emergency 51 order related to the COVID-19 pandemic is in effect. For the purposes of 52 this section, the "one-year United States treasury bill rate" means the 53 weekly average one-year constant maturity treasury yield, as published 54 by the board of governors of the federal reserve system, for the calen- 55 dar week preceding the date of the entry of the judgment awarding 56 damages.A. 1753 6 1 § 4. The insurance law is amended by adding a new section 3244 to read 2 as follows: 3 § 3244. Extension of premium payment periods; COVID-19. (a) Defi- 4 nitions. As used in this section, the following terms shall have the 5 following meanings: 6 (1) "Credit reporting agency" means a reporting agency that regularly 7 engages in the practice of assembling or evaluating and maintaining, for 8 the purpose of furnishing credit reports to third parties bearing on a 9 person's credit worthiness, credit standing, or credit capacity, and 10 credit account information from persons who furnish that information 11 regularly and in the ordinary course of business. 12 (2) "Late fee" means a fee associated with an insurance premium 13 payment that is made at a time later than the premium due date, but 14 prior to both insurance policy or contract termination and the time in 15 which an insurer, HMO, or student health plan may reject premium 16 payment. 17 (3) "Medical debt buyer" means a person or entity that is engaged in 18 the business of purchasing medical debts for collection purposes, wheth- 19 er it collects the debt itself or hires a third-party for collection or 20 an attorney for litigation in order to collect such debt. 21 (4) "Medical debt collector" means any person or entity that regularly 22 collects or attempts to collect, directly or indirectly, medical debts 23 originally owed or due or asserted to be owed or due to another. A 24 medical debt buyer is considered to be a medical debt collector for all 25 purposes. 26 (5) "Student health plan" has the meaning set forth in paragraph five 27 of subsection (a) of section one thousand one hundred twenty-four of 28 this chapter. 29 (6) "Child health plus" means coverage issued pursuant to section two 30 thousand five hundred eleven of the public health law. 31 (7) "HMO" shall mean a health maintenance organization operating in 32 accordance with the provisions of article forty-four of the public 33 health law or article forty-three of this chapter. 34 (b) Extension of premium payment periods. Every issuer of individual, 35 small group and student blanket comprehensive health insurance policies 36 subject to this article, as well as any issuer of a child health plus 37 policy where the policyholder or contract holder pays the entire premi- 38 um, shall, subject to consideration by the superintendent of the liquid- 39 ity and solvency of the applicable insurer, HMO, or student health plan, 40 extend the period for the payment of premiums for any policyholder or 41 contract holder who can demonstrate financial hardship as a result of 42 the COVID-19 pandemic to the later of the expiration of the applicable 43 contractual grace period and the date sixty days after a state disaster 44 emergency is no longer in effect with respect to the COVID-19 pandemic 45 anywhere in the state. Such an insurer, HMO, and student health plan 46 shall be responsible for the payment of claims during such period and 47 may not retroactively terminate the insurance policy for non-payment of 48 the premium during such period. 49 (c) Requirements. With regard to an individual, small group, or 50 student blanket comprehensive health insurance policyholder or contract 51 holder who does not make a timely premium payment and can demonstrate 52 financial hardship as a result of the COVID-19 pandemic, the applicable 53 insurer, HMO, or student health plan: (1) shall not impose any late fees 54 relating to such premium payment; (2) shall not report the policyholder 55 or contract holder to a credit reporting agency or refer the policyhold- 56 er or contract holder to a medical debt buyer or collector with respectA. 1753 7 1 to such premium payment; (3) shall provide information to the policy- 2 holder or contract holder regarding alternate policies available from 3 the insurer, HMO, or student health plan and provide contact information 4 for the NY state of health established pursuant to title seven of arti- 5 cle two of the public health law; and (4) shall provide information 6 regarding health insurance and medical debt consumer assistance avail- 7 able from the state designated consumer assistance program. 8 (d) Other provisions. (1) Subject to consideration by the superinten- 9 dent of the liquidity and solvency of the applicable insurer, HMO, or 10 student health plan, the insurer, HMO, or student health plan also 11 shall, within ten business days following the effective date of this 12 section: 13 (A) mail or deliver, which may include electronic mail, written notice 14 to every individual, small group, or student blanket comprehensive 15 health insurance policyholder and contract holder of the provisions of 16 this section and a toll-free number that the individual, small group, or 17 student blanket comprehensive health insurance policyholder or contract 18 holder may call to discuss billing and make alternative payment arrange- 19 ments; and 20 (B) notify insurance producers and any third-party administrators with 21 whom or which the insurer does business of the provisions of this 22 section. 23 (2) A licensed insurance producer who procured the individual, small 24 group, or student blanket comprehensive health insurance policy for the 25 policyholder or contract holder shall mail or deliver, which may include 26 electronic mail, notice to the policyholder or contract holder of the 27 provisions of this section within ten business days following the effec- 28 tive date of this section. 29 (3) Solely for the purposes of this section, an insurer, HMO, or 30 student health plan shall accept a written attestation from an individ- 31 ual, small group, or student blanket comprehensive policyholder or 32 contract holder as proof of financial hardship as a result of the 33 COVID-19 pandemic. 34 (4) Nothing in this section shall prohibit an individual, small group, 35 or student blanket comprehensive health insurance policyholder or 36 contract holder from voluntarily cancelling a health insurance policy. 37 (5) The period to pay insurance premiums set forth in this section 38 shall not constitute a waiver or forgiveness of the premium. 39 (6) The period set forth in subsection (b) of this section applies 40 only to terminations attributed to a failure by an individual, small 41 group, or student blanket comprehensive health insurance policyholder or 42 contract holder to pay premiums during such period. If an insurer, HMO, 43 or student health plan terminates a policy for any other reason permit- 44 ted by law, the insurer, HMO, or student health plan shall comply with 45 statutory notice requirements. 46 § 5. The insurance law is amended by adding a new section 4331 to read 47 as follows: 48 § 4331. Extension of premium payment periods; COVID-19. (a) Defi- 49 nitions. As used in this section, the following terms shall have the 50 following meanings: 51 (1) "Credit reporting agency" means a reporting agency that regularly 52 engages in the practice of assembling or evaluating and maintaining, for 53 the purpose of furnishing credit reports to third parties bearing on a 54 person's credit worthiness, credit standing, or credit capacity, and 55 credit account information from persons who furnish that information 56 regularly and in the ordinary course of business.A. 1753 8 1 (2) "Late fee" means a fee associated with an insurance premium 2 payment that is made at a time later than the premium due date, but 3 prior to both insurance policy or contract termination and the time in 4 which an insurer, HMO, or student health plan may reject premium 5 payment. 6 (3) "Medical debt buyer" means a person or entity that is engaged in 7 the business of purchasing medical debts for collection purposes, wheth- 8 er it collects the debt itself or hires a third-party for collection or 9 an attorney for litigation in order to collect such debt. 10 (4) "Medical debt collector" means any person or entity that regularly 11 collects or attempts to collect, directly or indirectly, medical debts 12 originally owed or due or asserted to be owed or due to another. A 13 medical debt buyer is considered to be a medical debt collector for all 14 purposes. 15 (5) "Student health plan" has the meaning set forth in paragraph five 16 of subsection (a) of section one thousand one hundred twenty-four of 17 this chapter. 18 (6) "Child health plus" means coverage issued pursuant to section two 19 thousand five hundred eleven of the public health law. 20 (7) "HMO" shall mean a health maintenance organization operating in 21 accordance with the provisions of article forty-four of the public 22 health law or this article. 23 (b) Extension of premium payment periods. Every medical expense indem- 24 nity corporation, HMO, hospital service corporation or health service 25 corporation subject to this article which issues direct pay, small group 26 or student blanket comprehensive contracts, as well as any issuer of 27 child health plus coverage where the subscriber pays the entire premium, 28 subject to consideration by the superintendent of the liquidity and 29 solvency of the applicable medical expense indemnity corporation, HMO, 30 hospital service corporation or health service corporation, shall extend 31 the period for the payment of premiums for any policyholder or contract 32 holder who can demonstrate financial hardship as a result of the COVID- 33 19 pandemic to the later of the expiration of the applicable contractual 34 grace period and the date sixty days after a state disaster emergency is 35 no longer in effect with respect to the COVID-19 pandemic anywhere in 36 the state. Such a medical expense indemnity corporation, HMO, hospital 37 service corporation or health service corporation shall be responsible 38 for the payment of claims during such period and may not retroactively 39 terminate the contract for non-payment of the premium during such peri- 40 od. 41 (c) Requirements. With regard to a direct pay, small group, or student 42 blanket comprehensive health insurance contract holder who does not make 43 a timely premium payment and can demonstrate financial hardship as a 44 result of the COVID-19 pandemic, the applicable medical expense indem- 45 nity corporation, HMO, hospital service corporation or health service 46 corporation: (1) shall not impose any late fees relating to such premium 47 payment; (2) shall not report the contract holder to a credit reporting 48 agency or refer the contract holder to a medical debt buyer or collector 49 with respect to such premium payment; (3) shall provide information to 50 the contract holder regarding alternate policies available from the 51 medical expense indemnity corporation, hospital service corporation or 52 health service corporation; and (4) shall provide information regarding 53 health insurance and medical debt consumer assistance available from the 54 state designated consumer assistance program. 55 (d) Other provisions. (1) Subject to consideration by the superinten- 56 dent of the liquidity and solvency of the applicable medical expenseA. 1753 9 1 indemnity corporation, HMO, hospital service corporation or health 2 service corporation, medical expense indemnity corporation, hospital 3 service corporation or health service corporation also shall, within ten 4 business days following the effective date of this section: 5 (A) mail or deliver, which may include electronic mail, written notice 6 to every direct pay, small group, or student blanket comprehensive 7 health insurance contract holder of the provisions of this section and a 8 toll-free number that the direct pay small group, or student blanket 9 comprehensive health contract holder may call to discuss billing and 10 make alternative payment arrangements; 11 (B) notify insurance producers and any third-party administrators with 12 whom or which the medical expense indemnity corporation, HMO, hospital 13 service corporation or health service corporation does business of the 14 provisions of this section. 15 (2) A licensed insurance producer who procured the direct pay, small 16 group, or student blanket comprehensive contract for the contract holder 17 shall mail or deliver, which may include electronic mail, notice to the 18 contract holder of the provisions of this section within ten business 19 days following the effective date of this section. 20 (3) Solely for the purposes of this section, a medical expense indem- 21 nity corporation, HMO, hospital service corporation or health service 22 corporation shall accept a written attestation from a direct pay, small 23 group, or student blanket comprehensive contract holder as proof of 24 financial hardship as a result of the COVID-19 pandemic. 25 (4) Nothing in this section shall prohibit a direct pay, small group, 26 or student blanket comprehensive contract holder from voluntarily 27 cancelling a contract. 28 (5) The period to pay premiums set forth in this section shall not 29 constitute a waiver or forgiveness of the premium. 30 (6) The period set forth in subsection (b) of this section applies 31 only to terminations attributed to a failure by a direct pay, small 32 group, or student blanket comprehensive contract holder to pay premiums 33 during such period. If a medical expense indemnity corporation, hospital 34 service corporation or health service corporation terminates a policy 35 for any other reason permitted by law, the insurer medical expense 36 indemnity corporation, hospital service corporation or health service 37 corporation shall comply with statutory notice requirements. 38 § 6. This act shall take effect immediately.