The Vermont Statutes Online

Title 18 : Health

Chapter 221 : Health Care Administration

Subchapter 010 : Patient Financial Assistance

• § 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.)