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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medical Debt Cancella-
tion Act’’. 
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SEC. 2. GRANTS TO CANCEL MEDICAL DEBT OWED BY PA-
TIENTS. 
Section 2799B–10 of the Public Health Service Act, 
as added by section 3, is amended by adding at the end 
the following: 
‘‘(e) GRANTS TO CANCEL MEDICAL DEBT OWED BY 
PATIENTS.— 
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish a grant program under which the Secretary, be-
ginning not later than 1 year after the date of enact-
ment of the Medical Debt Cancellation Act, awards 
grants on a competitive basis to hospitals in the 
United States in order to eliminate all eligible med-
ical debt owed by residents of the United States to 
such hospitals. 
‘‘(2) ELIGIBILITY.—To be eligible to receive a 
grant under this subsection, a hospital shall— 
‘‘(A) submit an application to the Sec-
retary at such time, in such manner, and con-
taining such information as the Secretary may 
require; and 
‘‘(B) agree to submit to the Secretary such 
reports regarding the use of grant funds as the 
Secretary may require. 
‘‘(3) PRIORITIZATION.—In awarding grants 
under this subsection, the Secretary shall— 
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‘‘(A) prioritize awards to hospitals that— 
‘‘(i) are safety net hospitals; and 
‘‘(ii) agree to cancel, at a minimum, 
all medical debt that is— 
‘‘(I) 15 months old or less; 
‘‘(II) owed by low-income and 
vulnerable patient populations; and 
‘‘(III) attributable to emergency 
and non-elective care; and 
‘‘(B) ensure that awards are distributed to 
hospitals across diverse geographical areas of 
the United States. 
‘‘(4) SUPPLEMENT, NOT
SUPPLANT.—Grants 
awarded to a hospital under this subsection shall be 
used to supplement, and not supplant, other sources 
of funding and investments made by the hospital for 
the purposes of providing financial assistance to pa-
tients. 
‘‘(5) EXPANSION OF MEDICAL DEBT CANCELLA-
TION.—Not later than 2 years after the date of en-
actment of the Medical Debt Cancellation Act, the 
Secretary shall expand the program under this sub-
section to allow providers and health care facilities 
other than hospitals, and individuals, to receive med-
ical debt cancellation. 
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‘‘(6) GUIDANCE.—Not later than 1 year after 
the date of enactment of the Medical Debt Cancella-
tion Act, the Secretary shall instruct Federal health 
care programs to eliminate medical debt collections. 
‘‘(7) CONSULTATION.—In carrying out this sub-
section, the Secretary shall consult with relevant 
Federal agencies, departments, and health pro-
grams, patient advocates, community-based organi-
zations with experience in medical debt cancellation, 
providers, and other key stakeholders. 
‘‘(8) REPORTING.—Beginning 2 years after the 
date of enactment of the Medical Debt Cancellation 
Act, and annually thereafter until the date on which 
the program under this subsection sunsets pursuant 
to paragraph (10), the Secretary shall submit to rel-
evant congressional committees a progress report on 
the implementation, administration, and impact of 
the program under this subsection. 
‘‘(9) DEFINITIONS.—In this subsection— 
‘‘(A) the term ‘eligible medical debt’— 
‘‘(i) means the out-of-pocket unpaid 
amount owed by a resident of the United 
States for items or services furnished to 
such individual by a hospital, provided 
that— 
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‘‘(I) such medical debt is in com-
pliance with applicable Federal laws 
and regulations, including— 
‘‘(aa) the medical billing re-
quirements of subsection (a); 
‘‘(bb) the medical debt col-
lection 
requirements 
of 
sub-
section (b); and 
‘‘(cc) the contracting limita-
tion under subsection (c); 
‘‘(II) such medical debt is with 
respect to items and services fur-
nished to an individual on or before 
the date of enactment of the Medical 
Debt Cancellation Act; and 
‘‘(III) any dispute resolution 
process under section 2799B–7 is 
complete; and 
‘‘(ii) excludes— 
‘‘(I) any amount paid or payable 
by any Federal health care program; 
and 
‘‘(II) with respect to items and 
services furnished to an individual by 
the hospital, any amount that is in ex-
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cess of the sum of the amount reim-
bursable by a Federal health care pro-
gram or other payer and copayment 
amounts under such a program or 
other health insurance plan with re-
spect to such items and services. 
‘‘(B) the term ‘Federal health care pro-
gram’ has the meaning given such term in sec-
tion 1128B(f) of the Social Security Act. 
‘‘(10) SUNSET.—The authorities under this 
subsection shall sunset on the date the Secretary 
certifies all eligible medical debt in the United 
States has been canceled under this subsection.’’. 
SEC. 3. REQUIREMENTS FOR MEDICAL BILLING PRACTICES 
AND MEDICAL DEBT COLLECTION; MEDICAL 
PAYMENT ASSISTANCE. 
(a) IN GENERAL.—Part E of title XXVII of the Pub-
lic Health Service Act (42 U.S.C. 300gg–131 et seq.) is 
amended by adding at the end the following new section: 
‘‘SEC. 2799B–10. REQUIREMENTS FOR MEDICAL BILLING 
AND MEDICAL DEBT COLLECTION; MEDICAL 
PAYMENT ASSISTANCE RESOURCE. 
‘‘(a) MEDICAL BILLING REQUIREMENTS.—In the 
case of a health care provider or facility that furnishes 
items or services to an individual, such provider or facility 
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shall, not later than 45 days before the date on which pay-
ment for such items or services is due— 
‘‘(1)(A) determine whether such individual is el-
igible for assistance with respect to such payment 
pursuant to the charity care or financial assistance 
policy of such provider or facility; and 
‘‘(B) if such individual is eligible for such as-
sistance, provide information to such individual re-
garding such assistance; and 
‘‘(2) on or after the date on which the medical 
payment assistance resource list under subsection 
(d)(1) is made available, provide such individual 
with such list. 
‘‘(b) 
MEDICAL
DEBT
COLLECTION
REQUIRE-
MENTS.— 
‘‘(1) IN GENERAL.—In the case of a health care 
provider or facility that furnishes items or services 
to an individual, if payment for such items or serv-
ices is past due, such provider or facility shall— 
‘‘(A) not later than 30 days after the date 
on which the payment was due, provide to such 
individual a statement (in clear and under-
standable language) that includes— 
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‘‘(i) subject to paragraph (2)(A), the 
total amount of the payment that remains 
due; 
‘‘(ii) a description of the attempts 
made by such provider or facility to deter-
mine whether such individual is eligible for 
assistance (as described in subsection 
(a)(1)) with respect to the payment; and 
‘‘(iii) in each of the 15 most com-
monly 
used 
languages 
(other 
than 
English), as determined by the Secretary, 
information 
about 
language-assistance 
services related to the payment that are 
available 
to 
individuals 
with 
limited 
English proficiency; and 
‘‘(B) not later than 30 days after a pay-
ment related to such items or services is made, 
provide to such individual a detailed receipt of 
such payment and a statement of the amount 
that remains due, if applicable. 
‘‘(2) 
LIMITATIONS
ON
MEDICAL
DEBT 
AMOUNTS.— 
‘‘(A) UNINSURED
INDIVIDUALS.—In the 
case of items or services furnished to an unin-
sured individual by an organization that is de-
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scribed in section 501(r)(2) of the Internal Rev-
enue Code of 1986 and is exempt from taxation 
under section 501(c)(3) of such Code, such or-
ganization may not collect payment from such 
individual with respect to such items or services 
in an amount greater than the amounts gen-
erally billed (within the meaning of section 
501(r) of such Code). 
‘‘(B) INTEREST RATE.—A health care pro-
vider or facility may not collect interest on past- 
due payments for items or services furnished to 
an individual. 
‘‘(c) LIMITATION ON CONTRACTING FOR PURPOSES 
OF MEDICAL BILLING
AND MEDICAL DEBT COLLEC-
TION.—A health care provider or facility may not enter 
into a contract with an entity for purposes of collecting 
payment with respect to items or services furnished by 
such provider or facility unless such entity agrees to com-
ply with the requirements described in subsections (a) and 
(b) for such provider or facility with respect to such pay-
ment. 
‘‘(d) MEDICAL PAYMENT ASSISTANCE RESOURCE 
LIST.— 
‘‘(1) IN GENERAL.—Not later than 1 year after 
the date of the enactment of the Medical Debt Can-
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cellation Act, the Secretary shall make publicly avail-
able on the website of the Department of Health and 
Human Services a comprehensive list of Federal, 
State, and local programs that provide financial as-
sistance with respect to payment for items or serv-
ices furnished by a health care provider or facility. 
‘‘(2) UPDATES.—The Secretary shall update 
the list described in paragraph (1) not less fre-
quently than annually.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply with respect to items and serv-
ices furnished on or after the date that is 1 year after 
the date of the enactment of this Act. 
(c) COORDINATION
AND CONSULTATION.—In car-
rying out this section, the Secretary of Health and Human 
Services shall— 
(1) coordinate with relevant Federal depart-
ments and agencies, including the Consumer Finan-
cial Protection Bureau and the Department of the 
Treasury; and 
(2) consult with relevant stakeholders including 
patient advocates, community-based organizations 
with experience in medical debt cancellation, and 
health care providers. 
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SEC. 4. MEDICAL DEBT COLLECTION. 
(a) COLLECTION OF MEDICAL DEBT.— 
(1) IN
GENERAL.—The Fair Debt Collection 
Practices Act (15 U.S.C. 1692 et seq.) is amended 
by inserting after section 818 (15 U.S.C. 1692p) the 
following: 
‘‘§ 818A. Collection of medical debt 
‘‘(a) IN GENERAL.—No debt collector or creditor may 
collect or attempt to collect debt that arose from the re-
ceipt of medical services, products, or devices if such debt 
was incurred by a consumer before the date of enactment 
of this section. 
‘‘(b) PRIVATE RIGHT OF ACTION.—Any consumer 
who is harmed by a violation of subsection (a) may bring 
a civil action in the appropriate United States district 
court against the debt collector or creditor that violated 
subsection (a) for— 
‘‘(1) compensatory damages, including for eco-
nomic losses and for emotional harm; 
‘‘(2) punitive damages; and 
‘‘(3) reasonable attorney’s fees and costs of the 
action to a prevailing plaintiff.’’. 
(b) TECHNICAL AND CONFORMING AMENDMENT.— 
The table of sections for the Fair Debt Collection Prac-
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tices Act (15 U.S.C. 1692 et seq.) is amended by inserting 
after the item relating to section 818 the following: 
‘‘818A. Collection of medical debt.’’. 
SEC. 5. MEDICAL DEBT REPORTING. 
(a) IN GENERAL.—Section 605(a) of the Fair Credit 
Reporting Act (15 U.S.C. 1681c(a)) is amended by adding 
at the end the following: 
‘‘(9) Any information related to debt that arose 
from the receipt of medical services, products, or de-
vices accrued by a consumer.’’. 
(b) NOTICE REQUIREMENTS.—Each credit reporting 
agency that removes information from the consumer re-
port of a consumer to comply with section 605(a)(9) of 
the Fair Credit Reporting Act, as added by subsection (a) 
of this section, shall notify the consumer of the removal. 
(c) EFFECTIVE DATE.—The amendment made by 
this section shall take effect on the date that is 30 days 
after the date of enactment of this section. 
Æ 
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