10-144 CMR Ch. 150 Charity Care and Financial Assistance Programs Rule

Date posted:

Attachment(s):

This rulemaking repeals and replaces  the current rule in force in order to comply with the significant changes caused by the enactment of PL 2025 c. 488 and also a previous statutory revision in 2017. The current rule in force has not been updated since 2007.

This proposed rule will repeal and replace the rule currently in force, and includes changes to definitions, application and eligibility requirements, patient notices and publication requirements, complaint and appeal procedures, payment plans and bill disputes, and enforcement actions.  Major changes include:

  • § 1(A): Pursuant to 22 M.R.S. § 1715(1), Hospital-Affiliated Providers are subject to this rule;
  • Adds definitions for:  Charity Care, Family Income, Federal Poverty Level, Hospital-Affiliated Provider, and State Resident;
  • § 3(C):  Pursuant to  22 M.R.S. § 1716-A(2), expands eligibility for charity care from 150% of FPL to 200% of FPL;
  • § 2(D)(Reasonable Payment Plans: Maximum Out-of-Pocket Payments):  Pursuant to 222 M.R.S. § 1716-A(8), requires Hospitals and Hospital-Affiliated Providers to offer patients with family income that does not exceed 400% of FPL a payment plan that requires monthly out of pocket payments that do not exceed 4% of the patient’s monthly family income;
  • § 4(G)(Translation Requirements):  Pursuant to 22 M.R.S. 1716-A(4)(B), requires Hospitals and Hospital-Affiliated Providers to provide translated versions of the charity care application and summaries, into any language spoken by 5% of the Maine population or 1,000 people in Maine, whichever is less;
  • § 8(A):  Clarifies the patient appeal process;
  • § 8(B):  Pursuant to 22 M.R.S. § 1716-A(11)(A):  Establishes a complaint procedure for patient complaints about Hospital or Hospital-Affiliated Providers noncompliance with this rule.

Office: Licensing and Certification

Public hearing: -

Meeting location:

109 Capitol St, Augusta, ME; Conference Room Maine A and B.

Comment deadline:

The comment period for this rule has closed.