An Act to Require Hospitals and Hospital-affiliated Providers to Provide Financial Assistance Programs for Medical Care
LD 1937 requires hospitals in Maine to provide and publicize financial assistance programs, including charity care, for qualifying patients. The bill defines charity care as free hospital services for eligible state residents with family income at or below 200% of the federal poverty level, and it also requires hospitals to offer reduced-cost financial assistance programs more broadly. Hospitals must screen patients for insurance or public assistance coverage, accept standardized proof of residency, provide translated applications and summaries in required languages, offer interpretation services, and give written notice of eligibility decisions and appeal rights.
The bill also sets detailed application and notice rules. Hospitals may not require notarization, may not ask for certain asset or income information for charity care, must respond to incomplete applications within set timelines, and must provide online applications by July 1, 2028. It requires hospitals to disclose on bills and in patient notices that financial assistance is available, to explain when specific services are not covered, and to offer payment plans for patients up to 400% of the federal poverty level with monthly payments capped at 4% of monthly family income. The bill repeals the prior hospital charity-care statute and replaces it with a new section, 22 MRSA §1716-A, while also updating related emergency care and debt collection laws to prevent billing or collection against patients who qualify for free or charity care.
The bill’s impact on state law is broad: it creates a new statewide hospital financial assistance framework, imposes new administrative duties on the Department of Health and Human Services, and authorizes enforcement through complaints, corrective action, and limited civil penalties. It also requires DHHS rulemaking by June 30, 2026, with rules aligned to federal Internal Revenue Code section 501(r), and includes a new department-developed application form and translation requirements. The act takes effect July 1, 2026, and includes funding and one new staff position to support implementation and enforcement.
The general sentiment reflected in the vote history suggests the bill was controversial and closely divided. The initial committee report and House/Senate floor votes show substantial support, but also significant opposition, and the chamber votes were narrow enough to indicate a polarized debate. The final vote to adopt a House amendment failed, suggesting disagreement over the bill’s scope or implementation details even after majority support for the underlying amended proposal.
The main points of contention appear to be the breadth of the hospital obligations, the administrative and compliance burden on hospitals, and the enforcement structure. Opponents likely focused on the mandated charity-care thresholds, limits on billing and collections, translation and notice requirements, and the new complaint and penalty process. Supporters appear to have favored stronger patient protections, clearer access to free or reduced-cost care, and more uniform statewide standards for hospital financial assistance.
The bill repeals the existing hospital charity-care statute and replaces it with a new, more detailed statewide framework in Title 22, section 1716-A, while also amending related emergency care and debt collection provisions. It expands hospital obligations to provide, publicize, and administer financial assistance programs; sets eligibility and notice standards; creates enforcement authority for DHHS and the Attorney General; and limits billing and collection against qualifying patients. It also requires DHHS rulemaking, a department-developed application, and implementation funding, with the new law taking effect July 1, 2026.
The bill appears to have drawn mixed but substantial support, with close votes indicating a divided legislature. The majority report advanced in committee and on the floor, but the narrow margins and the failed amendment vote suggest significant concern about the bill’s reach and implementation. Overall, the sentiment was supportive of expanding patient access to hospital financial assistance, but not without notable resistance to the regulatory and operational demands placed on hospitals.
The principal contention is between expanding patient protections and limiting burdens on hospitals. Supporters likely emphasized access to free or reduced-cost care, clearer application processes, language access, and protections against billing and collections for eligible patients. Opponents likely objected to the mandatory charity-care threshold, the prohibition on certain billing practices, the required translation and notice obligations, the online application mandate, and the enforcement penalties. The bill also includes an affirmative defense for hospitals claiming compliance would jeopardize economic viability, signaling concern about financial strain on providers.