,,ii  #aaf? ,,congress  #b;d ,session   
,s4 #dfig  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #bd1         
#bjbj,mr4 ,murphy 7= himself & ,mr4 ,van
 ,holl57 introduc$ ! foll[+ bill2 :i* 0 
read twice & ref]r$ to ! ,committee on  
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to am5d ! ,public ,heal?    
,s]vice ,act to provide additional      
transp>5cy & consum] protections relat+ 
to m$ical debt collection practices4    
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,/r5g!n+ ,consum] ,protections &      
,m$ical ,debt ,transp>5cy ,act4  #b4    
,m$ical debt collections  7a7 ,9 g5]al  
,"p ,c ( title ,,xxvii ( ! ,public      
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjj;gg-#ia et seq47 is am5d$ by add+ at
 ! end ! foll[+3  #bgie4 ,m$ical debt   
collections  7a7 ,def9itions  7#a7 ,9   
g5]al ,9 ?is section3 7,a7 ,database ,! 
t]m database means ! m$ical debt        
collection database e/abli%$ "u         
subsection 7e74  7,b7 ,debt collector ,!
 t]m debt collector has ! mean+ z def9$ 

"u ! ,fair ,debt ,collection ,practices 
,act4  7,c7 ,extraord9>y collection     
action ,! t]m extraord9>y collection    
action is z def9$ = purposes ( section  
#eja7r7 ( ! ,int]nal ,rev5ue ,code (    
#aihf 7z 9 effect on ! date ( enactm5t (
 ?is section74  7,d7 ,heal? c>e entity  
,! t]m heal? c>e entity means an entity 
def9$ pursuant to p>agraph 7#b74  7,e7  
,m$ical debt ,! t]m m$ical debt means   
debt aris+ f a pati5t's receipt ( m$ical
 s]vices1 products1 or devices4  7#b7   
,heal? c>e entity ,= purposes ( ?is     
section1 ! ,secret>y %all develop a     
def9ition ( ! t]m heal? c>e entity t    
%all include-- 7,a7 nonpr(it1 =-pr(it1  
critical access1 & canc] hospitals1     
includ+ hospital-own$ facilities2  7,b7 
indep5d5tly lic5s$ outpati5t1           
ambulatory1 behavioral1 optical1        
radiology1 laboratory1 d5tal1 & em]g5cy 
dep>tm5ts2  7,c7 physician gr\p         
practices1 ) an exemption = small       
practices1 z det]m9$ by ! ,secret>y2    
7,d7 physician /aff+ firms or physician 

s]vices companies2  7,e7 any heal? c>e  
ag5t ( an entity describ$ 9 ?is         
p>agraph2 &  7,f7 o!r entities z        
specifi$ by ! ,secret>y4  7b7           
,requirem5ts & prohibitions  7#a7 ,debt 
collection ,a heal? c>e entity1 or its  
debt collector1 %all n comm5ce1 or %all 
halt1 an extraord9>y collection action )
 respect to a pati5t if ! entity or its 
designee is notifi$ by any p>ty t a     
heal? insurance appeal is p5d+4  7#b7   
,det]m9ation ( eligibility = assi/ance  
,a heal? c>e entity1 or its debt        
collector1 %all n comm5ce any           
extraord9>y collection actions ) respect
 to a pati5t until ! entity det]m9es    
:e!r ! pati5t qualifies = assi/ance1    
ei!r ?r\gh enrollm5t 9 a ,f$]al or ,/ate
 program or ?r\gh ! entity's *>ity c>e  
or f9ancial assi/ance policy1 ) respect 
to su* debt4 ,! entity %all ref] su*    
pati5t to any su* assi/ance :]e         
available4  7#c7 ,prohibition on        
extraord9>y collection ,) respect to    
m$ical debt collection relat+ to a      

pati5t1 a heal? c>e entity1 or its debt 
collector1 %all n take any extraord9>y  
collection actions 7includ+ an action   
describ$ 9 sections #a4eja7r7-#f7;a77#b7
 ( title #bf1 ,code ( ,f$]al            
,regulations 7z 9 effect on ! date (    
enactm5t ( ?is section77 until !        
expiration ( ! #ahj-;day p]iod beg9n+ on
 ! date on :i* ! initial bill is s5t to 
! pati5t1 or a lat] date if applicable4 
7#d7 ,provid+ in=mation to pati5ts ,a   
heal? c>e entity or its debt collector  
%all provide a pati5t )-- 7,a7 an       
easy-to-und]/& itemiz$ /atem5t ( !      
m$ical debt ow$ by ! pati5t to ! heal?  
c>e entity prior to su* entity1 or !    
debt collector act+ on behalf ( !       
entity1 comm5c+ collection activities   
relat+ to su* debt2 &  7,b7 a copy ( !  
detail$ receipts ( any paym5ts made to !
 entity or its debt collector by !      
pati5t relat+ to ! m$ical debt involv$  
)9 #cj days ( su* paym5ts4  7#e7        
,limitation on recov]y by nonpr(it      
entities ,a heal? c>e entity t is a     

nonpr(it entity1 or its debt collector1 
%all n collect am\nts = ! m$ical debt ( 
a pati5t :o is n enroll$ 9 heal?        
insurance cov]age1 t are 9 excess ( !   
am\nt g5]ally bill$1 z describ$ 9       
sections #a4eja7r7-#a7;b77#a7 &         
#a4eja7r7-#e7;b7 ( title #bf1 ,code (   
,f$]al ,regulations4  7#f7 ,requirem5t (
 heal? c>e entity or its debt collector 
,prior to comm5c+ any debt collection   
activity ) respect to a m$ical debt1 !  
heal? c>e entity or its debt collector  
%all make all reasonable ef=ts to       
confirm ! id5tity ( ! debtor4  7#g7     
,limit on m$ical debt int]e/ ,! int]e/  
rate gr[? appli$ ) respect to any m$ical
 debt collect$ "u ?is section %all be   
set =? on ! initial m$ical bill1 b %all 
n exce$ #e p]c5t annually or ! annual   
rate set =? "u section #aifa ( title    
#bh1 ,unit$ ,/ates ,code1 = ! cal5d>    
week prec$+ ! date ( ! initial m$ical   
bill plus #b p]c5t1 :i*ev] is l[]4 ,?is 
subsection %all n be con/ru$ to limit   
assi/ance or a l[] int]e/ rate = a      

pati5t :o is o!rwise eligible = f9ancial
 assi/ance4  7c7 ,p5alties ,except z    
provid$ 9 ?is section1 a heal? c>e      
entity1 or its debt collector1 t fails  
to comply ) any provision ( ?is section 
) respect to a pati5t %all be liable to 
su* pati5t = damages 9 an am\nt equal to
 ! sum (-- 7#a7 any actual damages      
su/a9$ by su* pati5t z a result ( su*   
failure to comply2  7#b7 9 ! case ( an  
action comm5c$-- 7,a7 by an individual1 
any additional damages z ! c\rt may     
p]mit1 b n to exce$ #a1jjj = ea* failure
 to comply2 or  7,b7 by a class (       
pati5ts-- 7i7 su* am\nt = ea* nam$      
pla9tiff z c\ld be recov]$ "u p>agraph  
7#a7 & subp>agraph 7,a72 &  7ii7 su*    
am\nt z ! c\rt may all[ = all o!r class 
memb]s1 )\t reg>d to a m9imum individual
 recov]y1 n to exce$ ! less] (          
#b1jjj1jjj or #a p]c5t ( ! annual net   
income ( ! cov]$ provid]2 &  7#c7 9 !   
case ( any successful action "u ?is     
section1 ! co/s ( ! action1 toge!r ) a  
reasonable attorney's fee z det]m9$     

appropriate by ! c\rt4  7d7 ,e/abli%m5t 
( database  7#a7 ,9 g5]al ,! ,secret>y  
%all e/abli% & regul>ly update a m$ical 
debt collection public database4  7#b7  
,requir$ in=mation ,n lat] ?an #ab mon?s
 aft] ! date ( enactm5t ( ?is section1 &
 annually !reaft]1 a heal? c>e entity   
%all submit to ! database a debt        
collection report t %all include-- 7,a7 
! "n & contact in=mation ( any debt     
collector own$1 utiliz$1 or reta9$ by ! 
entity or to :i* ! entity assign$ or    
sold m$ical debt dur+ ! ye>2  7,b7 a    
description1 or l9k to su* description1 
( ! processes & policies ( ! entity =   
assign+ a m$ical debt to ! debt         
collector & = comp5sat+ su* collector = 
s]vices provid$ to ! entity2  7,c7 !    
type & numb] ( extraord9>y collection   
practices ! entity1 or debt collector   
report$ by ! entity pursuant to         
subp>agraph 7,a71 und]takes or seeks to 
und]take1 su* z wage g>ni%m5t1 bank     
acc\nt atta*m5ts1 li5s1 arre/ w>rants1  
report+ to a consum] report+ ag5cy1 &   

lawsuits2  7,d7 ! breakd[n1 by zip code1
 ( m$ical debt collection acc\nts ref]r$
 to a debt collector2  7,e7 ! recov]y   
rate on m$ical debt collection cases    
assign$ to ! debt collector1 z def9$ by 
! ,secret>y2  7,f7 ! numb] ( bills paid 
us+ a cr$it c>d2 &  7,g7 any o!r        
in=mation det]m9$ appropriate by !      
,secret>y4  7#c7 ,availability (        
in=mation ,! in=mation conta9$ 9 !      
database %all be available on a public1 
se>*able int]net website regul>ly updat$
 by ! ,secret>y4 ,! ,secret>y %all      
annually publi% a public li/ on         
,,hhs4gov ( any heal? c>e entity t fails
 to submit su* requir$ in=mation4  7#d7 
,,cfpb report ,n lat] ?an #ab mon?s aft]
 ! expiration ( two annual report+      
p]iods "u p>agraph 7#b71 ! ,director ( !
 ,consum] ,f9ancial ,protection ,bureau 
%all submit to ,congress a report       
conta9+ an analysis ( ! reports submitt$
 "u t p>agraph & an explanation ( :e!r !
 f9d+s bas$ on ! database "u ?is        
subsection are a useful tool = ! ag5cy's

 ,sup]vision ( ,nondepository ,cov]$    
,p]sons1 includ+ ! ,risk-,bas$          
,sup]vision ,program 7"u section #ajbd (
 ,public ,law #aaa-bjc74 ,su* report    
%all include recomm5dations to improve !
 disclosures by heal? c>e entities = !  
purposes ( sup]vis+ ! m$ical debt       
indu/ry1 includ+ = pr$ictive analytics1 
ma*9e le>n+1 or o!r analysis te*niques  
us$ 9 its ,risk-,bas$ ,sup]vision       
,program4  4  7b7 ,,cfpb report ,n lat] 
?an #ab mon?s aft] ! date ( enactm5t (  
?is ,act1 & e #b ye>s !reaft]1 !        
,consum] ,f9ancial ,protection ,bureau  
%all publicly report on m$ical debt     
collections1 incorporat+ data f ! m$ical
 debt collection public database        
e/abli%$ pursuant to section #bgie7;a7 (
 ! ,public ,heal? ,s]vice ,act1         
anonymiz$ data f ! ?ree l>ge/ cr$it     
bureaus1 ! ,consum] ,f9ancial           
,protection ,bureau database ( consum]  
compla9ts1 in=mation f ! ,consum]       
,f9ancial ,protection ,bureau's         
,sup]vision ( ,nondepository ,cov]$     

,p]sons program includ+ ! ,risk-,bas$   
,sup]vision ,program1 & relevant        
compla9ts & in=mation f o!r s\rces z    
available4