COVID–19 Medical Debt Collection Relief Act of 2021
Bill: S.355 | Sponsor: Sen. Van Hollen, Chris (D-MD)
Policy area: Health

Summary:
COVID-19 Medical Debt Collection Relief Act of 2021
This bill temporarily limits certain activities to collect medical debts by health care providers that apply for, or accept, COVID-19 (i.e., coronavirus 2019) financial relief.
Specifically, such health care providers must suspend extraordinary collection actions, such as selling a debt to a third-party collector or placing a lien on an individual's property, until the later of the end of the COVID-19 public health emergency or 18 months after the enactment of this bill.  Further, such health care providers must notify individuals who have entered into medical debt repayment plans that they may request the suspension of payments during such period. Providers must provide reasonable repayment options for individuals once repayments resume, such as extending repayment periods.
The bill also applies specified consumer protections to medical debt incurred for COVID-19-related testing and treatment between February 1, 2020, and 60 days after the COVID-19 public health emergency ends.

To provide immediate relief for patients from certain medical debt 
  collection efforts during and immediately after the COVID-19 public 
                           health emergency.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``COVID-19 Medical Debt Collection 
Relief Act of 2021''.

SEC. 2. RELIEF FROM MEDICAL DEBT COLLECTION.

    (a) Definitions.--In this section:
            (1) Covered period.--The term ``covered period'' means the 
        period beginning on February 1, 2020, and ending on the date 
        that is the later of--
                    (A) the end of the incident period with respect to 
                the emergency involving Federal primary responsibility 
                determined to exist by the President under section 
                501(b) of the Robert T. Stafford Disaster Relief and 
                Emergency Assistance Act (42 U.S.C. 5191(b)) with 
                respect to the coronavirus disease 2019 (COVID-19); or
                    (B) 18 months after the date of enactment of this 
                Act.
            (2) Covered provider.--The term ``covered provider'' means 
        any entity or individual that--
                    (A) provides health care services to patients; and
                    (B) has applied for or accepted any Federal funds 
                for COVID-19 health care costs or financial relief, 
                including funds allocated under the Families First 
                Coronavirus Response Act (Public Law 116-127), the 
                CARES Act (Public Law 116-136), or any other Federal 
                law that allocates COVID-19 relief funding.
            (3) Extraordinary collection actions.--The term 
        ``extraordinary collection actions'' means the actions 
        described in section 1.501(r)-6(b) of title 26, Code of Federal 
        Regulations.
            (4) Medical debt.--The term ``medical debt'' means a debt 
        arising from the receipt of medical services, products, or 
        devices.
            (5) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
    (b) Suspension of Collection Activities.--A covered provider and 
agents operating on behalf of covered providers shall suspend all 
extraordinary collection actions relating to the collection of a 
medical debt relating to a patient during the covered period.
    (c) Suspension of Repayment Plans.--
            (1) In general.--With respect to a patient who has entered 
        into a repayment plan with a covered provider relating to a 
        medical debt, such provider shall take the following actions:
                    (A) Include in patient billing a notification that 
                repayment plans for medical debt are available upon 
                request.
                    (B) Include in patient billing a notification that 
                any patient who has entered into a repayment plan with 
                the provider may request a suspension of the payment 
                plan during the covered period, and provide contact 
                information for the patient to make such request.
                    (C) Suspend such repayment plan upon the request of 
                the patient or the patient's guardian for the duration 
                of the covered period.
                    (D) Ensure the application of reasonable 
                forbearance and repayment options when such repayments 
                resume. Such options may include maintaining the same 
                payment schedule with respect to the medical debt by 
                extending the repayment period by the same period of 
                time that payments were suspended under this 
                subsection.
            (2) Guidance.--Not later than 14 days after the date of 
        enactment of this Act, the Secretary shall issue guidance on 
        best practices for notifying patients of their repayment 
        options, as described in paragraph (1). Such guidance shall 
        include taglines that alert individuals with limited English 
        proficiency (LEP) to the availability of language assistance 
        services.
            (3) Interest and fees.--Interest or fees shall not accrue 
        during the period in which a payment plan is suspended under 
        paragraph (1).
    (d) Application of Certain Consumer Protections.--
            (1) In general.--Medical debt incurred during the period 
        beginning on February 1, 2020, and ending on the date that is 
        60 days after the lifting of the state of emergency for COVID-
        19-related testing and treatment (as determined by the 
        Secretary) shall be subject to the following consumer 
        protections:
                    (A) A one-year extension of Federal and State 
                health insurance appeal deadlines, including the 
                deadlines set forth in section 2719 of the Public 
                Health Service Act (42 U.S.C. 300gg-19) and sections 
                2590.715 through 2179 of title 29, Code of Federal 
                Regulations, and the appeal and grievance deadlines for 
                the denials of Medicare or Medicaid claims under titles 
                XVIII and XIX of the Social Security Act (42 U.S.C. 
                1395 and 1396 et seq.).
                    (B) A prohibition on the accrual and collection of 
                fees and interest related to the medical debts 
                involved.
                    (C) A prohibition on any extraordinary collection 
                actions as described in sections 1.501(r)-(6)(b) of 
                title 26, Code of Federal Regulations.
            (2) COVID-19 related testing and treatment.--For purposes 
        of paragraph (1), the term ``COVID-19-related testing and 
        treatment'' includes items and services (including in-person or 
        telehealth visits in which such items and services are 
        furnished) that are furnished--
                    (A) to an individual who has been diagnosed with 
                (or after the provision of such items and services is 
                diagnosed with) COVID-19 to treat or mitigate the 
                effects of COVID-19; and
                    (B) to an individual who is presumed by a health 
                care provider to have COVID-19 but is never diagnosed 
                as such.
    (e) Penalties.--Except as provided in this section, a covered 
provider or its agent that fails to comply with any provision of this 
section with respect to a patient shall be liable to such patient for 
damages in an amount equal to the sum of--
            (1) any actual damages sustained by such patient as a 
        result of such failure to comply;
            (2) in the case of an action commenced--
                    (A) by an individual, any additional damages as the 
                court may permit, but not to exceed $1,000 for each 
                failure to comply; or
                    (B) by a class of patients--
                            (i) such amount for each named plaintiff as 
                        could be recovered under paragraph (1) and 
                        subparagraph (A); and
                            (ii) such amount as the court may allow for 
                        all other class members, without regard to a 
                        minimum individual recovery, not to exceed the 
                        lesser of $2,000,000 or 1 percent of the annual 
                        net income of the covered provider; and
            (3) in the case of any successful action under this 
        section, the costs of the action, together with a reasonable 
        attorney's fee as determined appropriate by the court.
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