I 

118TH CONGRESS 

2D SESSION H. R. 8311 

To cancel existing medical debt, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 8, 2024 

Mr. KHANNA (for himself, Ms. TLAIB, Mr. BOWMAN, Mr. CASAR, Ms. 

JAYAPAL, Ms. LEE of Pennsylvania, Mr. MCGOVERN, Ms. OMAR, Ms. 

PRESSLEY, Mrs. RAMIREZ, Ms. SCHAKOWSKY, Mr. TAKANO, and Ms. 

VELA ́ZQUEZ) introduced the following bill; which was referred to the 

Committee on Energy and Commerce, and in addition to the Committee 

on Financial Services, for a period to be subsequently determined by the 

Speaker, in each case for consideration of such provisions as fall within 

the jurisdiction of the committee concerned 

A BILL 

To cancel existing medical debt, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medical Debt Cancella5 tion Act’’. 


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1 SEC. 2. GRANTS TO CANCEL MEDICAL DEBT OWED BY PA2 TIENTS. 

3 Section 2799B–10 of the Public Health Service Act, 

4 as added by section 3, is amended by adding at the end 

5 the following: 

6 ‘‘(e) GRANTS TO CANCEL MEDICAL DEBT OWED BY

7 PATIENTS.— 

8 ‘‘(1) IN GENERAL.—The Secretary shall estab9 lish a grant program under which the Secretary, be10 ginning not later than 1 year after the date of enact11 ment of the Medical Debt Cancellation Act, awards 

12 grants on a competitive basis to hospitals in the 

13 United States in order to eliminate all eligible med14 ical debt owed by residents of the United States to 

15 such hospitals. 

16 ‘‘(2) ELIGIBILITY.—To be eligible to receive a 

17 grant under this subsection, a hospital shall— 

18 ‘‘(A) submit an application to the Sec19 retary at such time, in such manner, and con20 taining such information as the Secretary may 

21 require; and 

22 ‘‘(B) agree to submit to the Secretary such 

23 reports regarding the use of grant funds as the 

24 Secretary may require. 

25 ‘‘(3) PRIORITIZATION.—In awarding grants 

26 under this subsection, the Secretary shall— 


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1 ‘‘(A) prioritize awards to hospitals that— 

2 ‘‘(i) are safety net hospitals; and 

3 ‘‘(ii) agree to cancel, at a minimum, 

4 all medical debt that is— 

5 ‘‘(I) 15 months old or less; 

6 ‘‘(II) owed by low-income and 

7 vulnerable patient populations; and 

8 ‘‘(III) attributable to emergency 

9 and non-elective care; and 

10 ‘‘(B) ensure that awards are distributed to 

11 hospitals across diverse geographical areas of 

12 the United States. 

13 ‘‘(4) SUPPLEMENT, NOT SUPPLANT.—Grants 

14 awarded to a hospital under this subsection shall be 

15 used to supplement, and not supplant, other sources 

16 of funding and investments made by the hospital for 

17 the purposes of providing financial assistance to pa18 tients. 

19 ‘‘(5) EXPANSION OF MEDICAL DEBT CANCELLA20 TION.—Not later than 2 years after the date of en21 actment of the Medical Debt Cancellation Act, the 

22 Secretary shall expand the program under this sub23 section to allow providers and health care facilities 

24 other than hospitals, and individuals, to receive med25 ical debt cancellation. 


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1 ‘‘(6) GUIDANCE.—Not later than 1 year after 

2 the date of enactment of the Medical Debt Cancella3 tion Act, the Secretary shall instruct Federal health 

4 care programs to eliminate medical debt collections. 

5 ‘‘(7) CONSULTATION.—In carrying out this sub6 section, the Secretary shall consult with relevant 

7 Federal agencies, departments, and health pro8 grams, patient advocates, community-based organi9 zations with experience in medical debt cancellation, 

10 providers, and other key stakeholders. 

11 ‘‘(8) REPORTING.—Beginning 2 years after the 

12 date of enactment of the Medical Debt Cancellation 

13 Act, and annually thereafter until the date on which 

14 the program under this subsection sunsets pursuant 

15 to paragraph (10), the Secretary shall submit to rel16 evant congressional committees a progress report on 

17 the implementation, administration, and impact of 

18 the program under this subsection. 

19 ‘‘(9) DEFINITIONS.—In this subsection— 

20 ‘‘(A) the term ‘eligible medical debt’— 

21 ‘‘(i) means the out-of-pocket unpaid 

22 amount owed by a resident of the United 

23 States for items or services furnished to 

24 such individual by a hospital, provided 

25 that— 


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1 ‘‘(I) such medical debt is in com2 pliance with applicable Federal laws 

3 and regulations, including— 

4 ‘‘(aa) the medical billing re5 quirements of subsection (a); 

6 ‘‘(bb) the medical debt col7 lection requirements of sub8 section (b); and 

9 ‘‘(cc) the contracting limita10 tion under subsection (c); 

11 ‘‘(II) such medical debt is with 

12 respect to items and services fur13 nished to an individual on or before 

14 the date of enactment of the Medical 

15 Debt Cancellation Act; and 

16 ‘‘(III) any dispute resolution 

17 process under section 2799B–7 is 

18 complete; and 

19 ‘‘(ii) excludes— 

20 ‘‘(I) any amount paid or payable 

21 by any Federal health care program; 

22 and 

23 ‘‘(II) with respect to items and 

24 services furnished to an individual by 

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1 cess of the sum of the amount reim2 bursable by a Federal health care pro3 gram or other payer and copayment 

4 amounts under such a program or 

5 other health insurance plan with re6 spect to such items and services. 

7 ‘‘(B) the term ‘Federal health care pro8 gram’ has the meaning given such term in sec9 tion 1128B(f) of the Social Security Act. 

10 ‘‘(10) SUNSET.—The authorities under this 

11 subsection shall sunset on the date the Secretary 

12 certifies all eligible medical debt in the United 

13 States has been canceled under this subsection.’’. 

14 SEC. 3. REQUIREMENTS FOR MEDICAL BILLING PRACTICES 

15 AND MEDICAL DEBT COLLECTION; MEDICAL 

16 PAYMENT ASSISTANCE. 

17 (a) IN GENERAL.—Part E of title XXVII of the Pub18 lic Health Service Act (42 U.S.C. 300gg–131 et seq.) is 

19 amended by adding at the end the following new section: 

20 ‘‘SEC. 2799B–10. REQUIREMENTS FOR MEDICAL BILLING 

21 AND MEDICAL DEBT COLLECTION; MEDICAL 

22 PAYMENT ASSISTANCE RESOURCE. 

23 ‘‘(a) MEDICAL BILLING REQUIREMENTS.—In the 

24 case of a health care provider or facility that furnishes 

25 items or services to an individual, such provider or facility 


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1 shall, not later than 45 days before the date on which pay2 ment for such items or services is due— 

3 ‘‘(1)(A) determine whether such individual is el4 igible for assistance with respect to such payment 

5 pursuant to the charity care or financial assistance 

6 policy of such provider or facility; and 

7 ‘‘(B) if such individual is eligible for such as8 sistance, provide information to such individual re9 garding such assistance; and 

10 ‘‘(2) on or after the date on which the medical 

11 payment assistance resource list under subsection 

12 (d)(1) is made available, provide such individual 

13 with such list. 

14 ‘‘(b) MEDICAL DEBT COLLECTION REQUIRE15 MENTS.— 

16 ‘‘(1) IN GENERAL.—In the case of a health care 

17 provider or facility that furnishes items or services 

18 to an individual, if payment for such items or serv19 ices is past due, such provider or facility shall— 

20 ‘‘(A) not later than 30 days after the date 

21 on which the payment was due, provide to such 

22 individual a statement (in clear and under23 standable language) that includes— 


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1 ‘‘(i) subject to paragraph (2)(A), the 

2 total amount of the payment that remains 

3 due; 

4 ‘‘(ii) a description of the attempts 

5 made by such provider or facility to deter6 mine whether such individual is eligible for 

7 assistance (as described in subsection 

8 (a)(1)) with respect to the payment; and 

9 ‘‘(iii) in each of the 15 most com10 monly used languages (other than 

11 English), as determined by the Secretary, 

12 information about language-assistance 

13 services related to the payment that are 

14 available to individuals with limited 

15 English proficiency; and 

16 ‘‘(B) not later than 30 days after a pay17 ment related to such items or services is made, 

18 provide to such individual a detailed receipt of 

19 such payment and a statement of the amount 

20 that remains due, if applicable. 

21 ‘‘(2) LIMITATIONS ON MEDICAL DEBT

22 AMOUNTS.— 

23 ‘‘(A) UNINSURED INDIVIDUALS.—In the 

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1 scribed in section 501(r)(2) of the Internal Rev2 enue Code of 1986 and is exempt from taxation 

3 under section 501(c)(3) of such Code, such or4 ganization may not collect payment from such 

5 individual with respect to such items or services 

6 in an amount greater than the amounts gen7 erally billed (within the meaning of section 

8 501(r) of such Code). 

9 ‘‘(B) INTEREST RATE.—A health care pro10 vider or facility may not collect interest on past11 due payments for items or services furnished to 

12 an individual. 

13 ‘‘(c) LIMITATION ON CONTRACTING FOR PURPOSES

14 OF MEDICAL BILLING AND MEDICAL DEBT COLLEC15 TION.—A health care provider or facility may not enter 

16 into a contract with an entity for purposes of collecting 

17 payment with respect to items or services furnished by 

18 such provider or facility unless such entity agrees to com19 ply with the requirements described in subsections (a) and 

20 (b) for such provider or facility with respect to such pay21 ment. 

22 ‘‘(d) MEDICAL PAYMENT ASSISTANCE RESOURCE

23 LIST.— 

24 ‘‘(1) IN GENERAL.—Not later than 1 year after 

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1 cellation Act, the Secretary shall make publicly avail2 able on the website of the Department of Health and 

3 Human Services a comprehensive list of Federal, 

4 State, and local programs that provide financial as5 sistance with respect to payment for items or serv6 ices furnished by a health care provider or facility. 

7 ‘‘(2) UPDATES.—The Secretary shall update 

8 the list described in paragraph (1) not less fre9 quently than annually.’’. 

10 (b) EFFECTIVE DATE.—The amendments made by 

11 subsection (a) shall apply with respect to items and serv12 ices furnished on or after the date that is 1 year after 

13 the date of the enactment of this Act. 

14 (c) COORDINATION AND CONSULTATION.—In car15 rying out this section, the Secretary of Health and Human 

16 Services shall— 

17 (1) coordinate with relevant Federal depart18 ments and agencies, including the Consumer Finan19 cial Protection Bureau and the Department of the 

20 Treasury; and 

21 (2) consult with relevant stakeholders including 

22 patient advocates, community-based organizations 

23 with experience in medical debt cancellation, and 

24 health care providers. 


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1 SEC. 4. MEDICAL DEBT COLLECTION. 

2 (a) COLLECTION OF MEDICAL DEBT.— 

3 (1) IN GENERAL.—The Fair Debt Collection 

4 Practices Act (15 U.S.C. 1692 et seq.) is amended 

5 by inserting after section 818 (15 U.S.C. 1692p) the 

6 following: 

7 ‘‘§ 818A. Collection of medical debt 

8 ‘‘(a) IN GENERAL.—No debt collector or creditor may 

9 collect or attempt to collect debt that arose from the re10 ceipt of medical services, products, or devices if such debt 

11 was incurred by a consumer before the date of enactment 

12 of this section. 

13 ‘‘(b) PRIVATE RIGHT OF ACTION.—Any consumer 

14 who is harmed by a violation of subsection (a) may bring 

15 a civil action in the appropriate United States district 

16 court against the debt collector or creditor that violated 

17 subsection (a) for— 

18 ‘‘(1) compensatory damages, including for eco19 nomic losses and for emotional harm; 

20 ‘‘(2) punitive damages; and 

21 ‘‘(3) reasonable attorney’s fees and costs of the 

22 action to a prevailing plaintiff.’’. 

23 (b) TECHNICAL AND CONFORMING AMENDMENT.— 

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1 tices Act (15 U.S.C. 1692 et seq.) is amended by inserting 

2 after the item relating to section 818 the following: 

‘‘818A. Collection of medical debt.’’. 

3 SEC. 5. MEDICAL DEBT REPORTING. 

4 (a) IN GENERAL.—Section 605(a) of the Fair Credit 

5 Reporting Act (15 U.S.C. 1681c(a)) is amended by adding 

6 at the end the following: 

7 ‘‘(9) Any information related to debt that arose 

8 from the receipt of medical services, products, or de9 vices accrued by a consumer.’’. 

10 (b) NOTICE REQUIREMENTS.—Each credit reporting 

11 agency that removes information from the consumer re12 port of a consumer to comply with section 605(a)(9) of 

13 the Fair Credit Reporting Act, as added by subsection (a) 

14 of this section, shall notify the consumer of the removal. 

15 (c) EFFECTIVE DATE.—The amendment made by 

16 this section shall take effect on the date that is 30 days 

17 after the date of enactment of this section. 

Æ 


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