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MaineLD 1937132nd Maine Legislature (2025-2026)SenateWALLET

An Act to Require Hospitals and Hospital-affiliated Providers to Provide Financial Assistance Programs for Medical Care

Sponsored By: Rachel Talbot Ross (Democratic)

Became Law

HEALTH CARE FACILITIESHEALTH CARE FACILITIES - HOSPITALS

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Bill Overview

Analyzed Economic Effects

5 provisions identified: 4 benefits, 0 costs, 1 mixed.

Free hospital care for low‑income residents

Beginning July 1, 2026, hospitals must give free, medically necessary care to state residents with family income at or below 200% of the federal poverty level. Hospitals must check income two ways: last 3 months multiplied by 4, or the last 12 months. If one method does not fit, they must use the other. These same rules apply to hospital‑affiliated outpatient and major ambulatory providers, and providers that needed a certificate of need.

Clear notices and billing transparency

Beginning July 1, 2026, hospitals must widely share financial help information in the hospital, on their website, and on billing statements. They must post a plain‑language summary (including any services not covered) and the full application online. Each inpatient gets written notice at admission (or before discharge after an emergency). Outpatients get notice at the visit or with the bill. Notices must include how to get a paper form, the website, income rules, and denial reasons. Every bill must explain how to dispute a charge and list a separate dispute contact if it differs from billing. If you are approved for assistance, the hospital must tell you in advance if part of your care is not covered. If it does not, it cannot bill you for that part, though it may bill your insurer.

Easier applications and language access

Starting July 1, 2026, hospitals must use the state’s financial help application, accept approved proofs of residency, and may not require notarization. Eligibility is based on your family income at the time you apply. Hospitals must tell you within 15 days if something is missing, give you at least 30 days to respond, and decide within 45 days of a complete application. They must provide interpreters for people with limited English and for people who are deaf or hard of hearing. Forms and summaries are translated into any language spoken by 5% of Maine or 1,000 people statewide, and into languages meeting the same 5% or 1,000 test in the hospital’s community. If you are denied, you must get a written reason and information on your right to a fair hearing. By July 1, 2028, you can apply online, get an email receipt, or ask for a paper form by mail. Hospitals may not ask about assets or income that are not part of MAGI.

Lower payments and stronger debt protections

Starting July 1, 2026, if your family income is at or below 400% of the poverty level, the hospital must offer a payment plan. Your monthly out‑of‑pocket payments are capped at 4% of your monthly family income that is not exempt from garnishment. If you meet the charity‑care financial rules, the hospital cannot bill you or your municipality for hospital services. The hospital must notify the town overseer within 5 business days of an eligible admission. If a debt collector is told you are qualified or likely qualified for good cause, the collector must stop trying to collect until told you are not eligible.

Stronger enforcement and 60‑day appeal limit

By June 30, 2026, the Department adopts rules for these programs, aligned with federal 501(r). Starting July 1, 2026, patients can file complaints; the Department reviews within 30 days and can require fixes. For knowing or repeat violations, the Attorney General can seek penalties up to $1,000. Separately, knowingly denying access can bring $200–$500 per patient in fines, capped at $5,000 for a first judgment, $7,500 for a second, and $10,000 for later judgments. Appeals are time‑limited: you must request an administrative hearing within 60 days after the written notice. The state adds one staff position to run applications and enforcement, funded at $40,188 (General Fund) and $79,822 (Other Special Revenue) for FY 2026–27. On July 1, 2026, the old charity‑care statute is repealed and replaced by these rules.

Sponsors & Cosponsors

Sponsor

  • Rachel Talbot Ross

    Democratic • Senate

Cosponsors

  • Daniel Shagoury

    Democratic • House

  • Donna Bailey

    Democratic • Senate

  • Drew Gattine

    Democratic • House

  • Henry L. Ingwersen

    Democratic • Senate

  • Holly Stover

    Democratic • House

  • Joseph M. Baldacci

    Democratic • Senate

  • Peggy R. Rotundo

    Democratic • Senate

  • Michele Meyer

    Democratic • House

  • Ryan Fecteau

    Democratic • House

Roll Call Votes

All Roll Calls

Yes: 167 • No: 162

House vote • 6/17/2025

ACC MAJ OTP AS AMENDED REP

Yes: 75 • No: 72

House vote • 6/17/2025

ADOPT HAH-707 TO CAS-346

Yes: 71 • No: 76

Senate vote • 6/12/2025

ACCEPT MAJORITY OUGHT TO PASS AS AMENDED REPORT

Yes: 21 • No: 14

Actions Timeline

  1. ACTPUB Chapter 488

    5/1/2026

  2. On motion by Senator ROTUNDO of Androscoggin taken from the Special Appropriations Table PASSED TO BE ENACTED in concurrence.

    6/25/2025Senate

  3. On motion by Senator ROTUNDO of Androscoggin PLACED ON THE SPECIAL APPROPRIATIONS TABLE pending ENACTMENT in concurrence

    6/17/2025Senate

  4. PASSED TO BE ENACTED. Sent for concurrence. ORDERED SENT FORTHWITH.

    6/17/2025House

  5. Speaker laid before the HouseSubsequently, on motion of Representative MEYER of Eliot, the Majority Ought to Pass as Amended Report was ACCEPTED.ROLL CALL NO. 543(Yeas 75 - Nays 72 - Absent 2 - Excused 2)The Bill was READ ONCE.Committee Amendment "A" (S-346) was READ.On motion of Representative JAVNER of Chester, House Amendment "A" (H-707) to Committee Amendment "A" (S-346) was READ.Subsequently, House Amendment "A" (H-707) to Committee Amendment "A" (S-346) FAILED ADOPTION.ROLL CALL NO. 544(Yeas 71 - Nays 76 - Absent 2 - Excused 2)Subsequently, Committee Amendment "A" (S-346) was ADOPTED.Under suspension of the rules, the Bill was given its SECOND READING without REFERENCE to the Committee on Bills in the Second Reading.The Bill was PASSED TO BE ENGROSSED as Amended by Committee Amendment "A" (S-346).In concurrence. ORDERED SENT FORTHWITH.

    6/17/2025House

  6. Unfinished Business

    6/16/2025House

  7. Unfinished Business

    6/13/2025House

  8. Reports READ.On motion of Representative MEYER of Eliot, TABLED pending ACCEPTANCE of Either Report.Later today assigned.

    6/13/2025House

  9. On motion by Senator INGWERSEN of York Tabled until Later in Today's Session, pending ACCEPTANCE OF EITHER REPORT Taken from the table by the President On motion by Senator PIERCE of Cumberland The Majority Ought to Pass As Amended by Committee Amendment "A" (S-346) Report ACCEPTED PREVAILED Roll Call Ordered Roll Call Number 487 Yeas 21 - Nays 14 - Excused 0 - Absent 0 READ ONCE Committee Amendment "A" (S-346) READ and ADOPTED Under suspension of the Rules, READ A SECOND TIME and PASSED TO BE ENGROSSED AS AMENDED by Committee Amendment "A" (S-346) Sent down for concurrence.

    6/12/2025Senate

  10. The Bill was REFERRED to the Committee on HEALTH AND HUMAN SERVICES.In concurrence. ORDERED SENT FORTHWITH.

    5/7/2025House

  11. Committee on HEALTH COVERAGE, INSURANCE AND FINANCIAL SERVICES suggested and ordered printed On motion by Senator BAILEY of York REFERENCE to the Committee on HEALTH AND HUMAN SERVICES Ordered sent down forthwith for concurrence

    5/7/2025Senate

Bill Text

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