II 

117TH CONGRESS 

1ST SESSION S. 355 

To provide immediate relief for patients from certain medical debt collection 

efforts during and immediately after the COVID–19 public health emergency. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 22, 2021 

Mr. VAN HOLLEN (for himself, Mr. MERKLEY, Mr. BROWN, and Mr. 

BLUMENTHAL) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To provide immediate relief for patients from certain medical 

debt collection efforts during and immediately after the 

COVID–19 public health emergency. 

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 ‘‘COVID–19 Medical 

5 Debt Collection Relief Act of 2021’’. 

6 SEC. 2. RELIEF FROM MEDICAL DEBT COLLECTION. 

7 (a) DEFINITIONS.—In this section: 


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1 (1) COVERED PERIOD.—The term ‘‘covered pe2 riod’’ means the period beginning on February 1, 

3 2020, and ending on the date that is the later of— 

4 (A) the end of the incident period with re5 spect to the emergency involving Federal pri6 mary responsibility determined to exist by the 

7 President under section 501(b) of the Robert T. 

8 Stafford Disaster Relief and Emergency Assist9 ance Act (42 U.S.C. 5191(b)) with respect to 

10 the coronavirus disease 2019 (COVID–19); or 

11 (B) 18 months after the date of enactment 

12 of this Act. 

13 (2) COVERED PROVIDER.—The term ‘‘covered 

14 provider’’ means any entity or individual that— 

15 (A) provides health care services to pa16 tients; and 

17 (B) has applied for or accepted any Fed18 eral funds for COVID–19 health care costs or 

19 financial relief, including funds allocated under 

20 the Families First Coronavirus Response Act 

21 (Public Law 116–127), the CARES Act (Public 

22 Law 116–136), or any other Federal law that 

23 allocates COVID–19 relief funding. 

24 (3) EXTRAORDINARY COLLECTION ACTIONS.— 

25 The term ‘‘extraordinary collection actions’’ means 


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1 the actions described in section 1.501(r)–6(b) of title 

2 26, Code of Federal Regulations. 

3 (4) MEDICAL DEBT.—The term ‘‘medical debt’’ 

4 means a debt arising from the receipt of medical 

5 services, products, or devices. 

6 (5) SECRETARY.—The term ‘‘Secretary’’ means 

7 the Secretary of Health and Human Services. 

8 (b) SUSPENSION OF COLLECTION ACTIVITIES.—A 

9 covered provider and agents operating on behalf of covered 

10 providers shall suspend all extraordinary collection actions 

11 relating to the collection of a medical debt relating to a 

12 patient during the covered period. 

13 (c) SUSPENSION OF REPAYMENT PLANS.— 

14 (1) IN GENERAL.—With respect to a patient 

15 who has entered into a repayment plan with a cov16 ered provider relating to a medical debt, such pro17 vider shall take the following actions: 

18 (A) Include in patient billing a notification 

19 that repayment plans for medical debt are 

20 available upon request. 

21 (B) Include in patient billing a notification 

22 that any patient who has entered into a repay23 ment plan with the provider may request a sus24 pension of the payment plan during the covered 


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1 period, and provide contact information for the 

2 patient to make such request. 

3 (C) Suspend such repayment plan upon 

4 the request of the patient or the patient’s 

5 guardian for the duration of the covered period. 

6 (D) Ensure the application of reasonable 

7 forbearance and repayment options when such 

8 repayments resume. Such options may include 

9 maintaining the same payment schedule with 

10 respect to the medical debt by extending the re11 payment period by the same period of time that 

12 payments were suspended under this sub13 section. 

14 (2) GUIDANCE.—Not later than 14 days after 

15 the date of enactment of this Act, the Secretary 

16 shall issue guidance on best practices for notifying 

17 patients of their repayment options, as described in 

18 paragraph (1). Such guidance shall include taglines 

19 that alert individuals with limited English pro20 ficiency (LEP) to the availability of language assist21 ance services. 

22 (3) INTEREST AND FEES.—Interest or fees 

23 shall not accrue during the period in which a pay24 ment plan is suspended under paragraph (1). 


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1 (d) APPLICATION OF CERTAIN CONSUMER PROTEC2 TIONS.— 

3 (1) IN GENERAL.—Medical debt incurred dur4 ing the period beginning on February 1, 2020, and 

5 ending on the date that is 60 days after the lifting 

6 of the state of emergency for COVID–19-related 

7 testing and treatment (as determined by the Sec8 retary) shall be subject to the following consumer 

9 protections: 

10 (A) A one-year extension of Federal and 

11 State health insurance appeal deadlines, includ12 ing the deadlines set forth in section 2719 of 

13 the Public Health Service Act (42 U.S.C. 

14 300gg–19) and sections 2590.715 through 

15 2179 of title 29, Code of Federal Regulations, 

16 and the appeal and grievance deadlines for the 

17 denials of Medicare or Medicaid claims under 

18 titles XVIII and XIX of the Social Security Act 

19 (42 U.S.C. 1395 and 1396 et seq.). 

20 (B) A prohibition on the accrual and col21 lection of fees and interest related to the med22 ical debts involved. 

23 (C) A prohibition on any extraordinary col24 lection actions as described in sections 


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1 1.501(r)–(6)(b) of title 26, Code of Federal 

2 Regulations. 

3 (2) COVID–19 RELATED TESTING AND TREAT4 MENT.—For purposes of paragraph (1), the term 

5 ‘‘COVID–19-related testing and treatment’’ includes 

6 items and services (including in-person or telehealth 

7 visits in which such items and services are fur8 nished) that are furnished— 

9 (A) to an individual who has been diag10 nosed with (or after the provision of such items 

11 and services is diagnosed with) COVID–19 to 

12 treat or mitigate the effects of COVID–19; and 

13 (B) to an individual who is presumed by a 

14 health care provider to have COVID–19 but is 

15 never diagnosed as such. 

16 (e) PENALTIES.—Except as provided in this section, 

17 a covered provider or its agent that fails to comply with 

18 any provision of this section with respect to a patient shall 

19 be liable to such patient for damages in an amount equal 

20 to the sum of— 

21 (1) any actual damages sustained by such pa22 tient as a result of such failure to comply; 

23 (2) in the case of an action commenced— 


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1 (A) by an individual, any additional dam2 ages as the court may permit, but not to exceed 

3 $1,000 for each failure to comply; or 

4 (B) by a class of patients— 

5 (i) such amount for each named plain6 tiff as could be recovered under paragraph 

7 (1) and subparagraph (A); and 

8 (ii) such amount as the court may 

9 allow for all other class members, without 

10 regard to a minimum individual recovery, 

11 not to exceed the lesser of $2,000,000 or 

12 1 percent of the annual net income of the 

13 covered provider; and 

14 (3) in the case of any successful action under 

15 this section, the costs of the action, together with a 

16 reasonable attorney’s fee as determined appropriate 

17 by the court. 

Æ 


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