Amd §§5201 & 7501, CPLR; amd §601, Gen Bus L; add §2832, Pub Health L
Prohibits money judgments arising from non-payment of facility items and services by a patient or patient guarantor that is brought by a facility; prohibits the enforcement of arbitration agreements or clauses with respect to non-payment of facility items and services by a patient or patient guarantor; relates to the collection of medical debt; requires transparency in hospital pricing.
STATE OF NEW YORK
________________________________________________________________________
7479
2025-2026 Regular Sessions
IN SENATE
April 17, 2025
___________
Introduced by Sen. HOYLMAN-SIGAL -- read twice and ordered printed, and
when printed to be committed to the Committee on Judiciary
AN ACT to amend the civil practice law and rules, the general business
law and the public health law, in relation to medical debt
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivision (a) of section 5201 of the civil practice law
2 and rules is amended to read as follows:
3 (a) Debt against which a money judgment may be enforced. A money judg-
4 ment may be enforced against any debt, which is past due or which is yet
5 to become due, certainly or upon demand of the judgment debtor, whether
6 it was incurred within or without the state, to or from a resident or
7 non-resident, unless it is exempt from application to the satisfaction
8 of the judgment. A debt may consist of a cause of action which could be
9 assigned or transferred accruing within or without the state. No money
10 judgment shall be sought, entered, or enforced in an action arising from
11 non-payment of facility items and services by a patient or patient guar-
12 antor that is brought by a facility, as defined under section twenty-
13 eight hundred thirty-two of the public health law, that is in material
14 noncompliance with section twenty-eight hundred thirty-two of the public
15 health law on the date that the relevant facility items or services are
16 purchased from a provider to a patient by the facility in material
17 noncompliance.
18 § 2. Section 7501 of the civil practice law and rules, as amended by
19 chapter 532 of the laws of 1963, is amended to read as follows:
20 § 7501. Effect of arbitration agreement. A written agreement to submit
21 any controversy thereafter arising or any existing controversy to arbi-
22 tration is enforceable without regard to the justiciable character of
23 the controversy and confers jurisdiction on the courts of the state to
24 enforce it and to enter judgment on an award. In determining any matter
25 arising under this article, the court shall not consider whether the
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD08384-01-5
S. 7479 2
1 claim with respect to which arbitration is sought is tenable, or other-
2 wise pass upon the merits of the dispute. No facility, as defined under
3 section twenty-eight hundred thirty-two of the public health law, shall
4 enforce an arbitration agreement or clause in any facility document,
5 including contracts, agreements, statements, or bills, in an action
6 arising from patient or patient guarantor non-payment of facility items
7 or services, if that facility is in material noncompliance with section
8 twenty-eight hundred thirty-two of the public health law on the date
9 that the relevant facility items or services are purchased from a
10 provider to a patient by the facility in material noncompliance.
11 § 3. Section 601 of the general business law is amended by adding two
12 new subdivisions 13 and 14 to read as follows:
13 13. Attempt to collect a medical debt, or debt arising from nonpayment
14 of facility items and services, from a patient or patient guarantor by
15 referring the debt, directly or indirectly, to a debt collector or debt
16 collection agency if the principal creditor is a facility, as defined by
17 section twenty-eight hundred thirty-two of the public health law, or an
18 affiliate, that is in material noncompliance with section twenty-eight
19 hundred thirty-two of the public health law on the date that the rele-
20 vant facility items or services are purchased from a provider to a
21 patient by the facility; or
22 14. Disclose or cause to be disclosed information affecting the
23 debtor's reputation for credit worthiness, including to a consumer cred-
24 it reporting agency as defined in article twenty-five of this chapter,
25 if the principal creditor is a facility, as defined by section twenty-
26 eight hundred thirty-two of the public health law, or an affiliate, that
27 is in material noncompliance with section twenty-eight hundred thirty-
28 one of the public health law on the date that the relevant facility
29 items or services are purchased from a provider to a patient by the
30 facility, and the action arose from patient or patient guarantor non-
31 payment of facility items or services.
32 § 4. The public health law is amended by adding a new section 2832 to
33 read as follows:
34 § 2832. The hospital price transparency act. 1. As used in this
35 section:
36 (a) "Ancillary service" means a facility item or service that a facil-
37 ity customarily provides as part of or in conjunction with a shoppable
38 primary service.
39 (b) "Chargemaster" means the list of all facility items and services
40 maintained by a facility for which the facility has established a
41 charge.
42 (c) "Collections action" includes any of the following actions taken
43 with respect to a debt for items and services that were purchased from
44 or provided to a patient by a facility:
45 (i) attempting to collect a debt from a patient or patient guarantor
46 by referring the debt, directly or indirectly, to a debt collector, a
47 collection agency, or other third-party retained by or on behalf of the
48 facility;
49 (ii) initiating a lawsuit against the patient or patient guarantor, or
50 enforcing an arbitration or mediation clause in any facility documents
51 including contracts, agreements, statements, or bills; or
52 (iii) directly or indirectly causing a report to be made to a consumer
53 reporting agency.
54 (d) "De-identified maximum negotiated charge" means the highest charge
55 that a facility has negotiated with all third-party payers for a facili-
56 ty item or service.
S. 7479 3
1 (e) "De-identified minimum negotiated charge" means the lowest charge
2 that a facility has negotiated with all third-party payers for a facili-
3 ty item or service.
4 (f) "Discounted cash price" means the charge that applies to an indi-
5 vidual who pays cash, or cash equivalent, for a facility item or
6 service.
7 (g) "Facility" includes the following:
8 (i) general hospitals as defined in section twenty-eight hundred one
9 of this article; and
10 (ii) any hospital, as defined in section twenty-eight hundred one of
11 this article, to which the department determines this section should
12 apply.
13 (h) "Gross charge" means the charge for a facility item or service
14 that is reflected on a facility's chargemaster, absent any discounts.
15 (i) "Facility items and services" and any variation of this phrase
16 means all items and services, including individual items and services
17 and service packages, that may be provided by a facility to a patient in
18 connection with an inpatient admission or an outpatient department visit
19 for which the facility has established a standard charge. This includes,
20 but is not limited to:
21 (i) supplies and procedures;
22 (ii) room and board;
23 (iii) use of the facility and other areas, the charges for which are
24 generally referred to as facility fees;
25 (iv) services of physicians and non-physician practitioners, employed
26 by the facility, the charges for which are generally referred to as
27 professional charges; and
28 (v) any other item or service for which a facility has established a
29 standard charge.
30 (j) "Machine-readable format" means a digital representation of data
31 or information in a file that can be imported or read into a computer
32 system for further processing, including .XML, .JSON, and .CSV formats.
33 (k) "Payer-specific negotiated charge" means the charge that a facili-
34 ty has negotiated with a third-party payer for a facility item or
35 service.
36 (l) "Service package" means an aggregation of individual facility
37 items and services into a single service with a single charge.
38 (m) "Shoppable service" means a service that may be scheduled by a
39 health care consumer in advance.
40 (n) "Standard charge" means the regular rate established by the facil-
41 ity for a facility item or service provided to a specific group of
42 paying patients. This term includes all of the following, as defined
43 under this section:
44 (i) the gross charge;
45 (ii) the payer-specific negotiated charge;
46 (iii) the de-identified minimum negotiated charge;
47 (iv) the de-identified maximum negotiated charge; and
48 (v) the discounted cash price.
49 (o) "Third-party payer" means an entity that is, by statute, contract,
50 or agreement, legally responsible for payment of a claim for a facility
51 item or service.
52 2. Notwithstanding any other law, a facility must make public the
53 following:
54 (a) a digital file in a machine-readable format that contains a list
55 of all standard charges for all facility items and services as provided
56 in subdivision three of this section; and
S. 7479 4
1 (b) a consumer-friendly list of standard charges for a limited set of
2 shoppable services as provided in subdivision three of this section.
3 3. (a) A facility shall maintain a list of all standard charges for
4 all facility items and services in accordance with this section. This
5 list must include, as applicable:
6 (i) a description of each facility item or service provided by the
7 facility; and
8 (ii) the following charges for each individual facility item or
9 service when provided in either an inpatient setting or an outpatient
10 department setting, as applicable:
11 (A) the gross charge;
12 (B) the de-identified minimum negotiated charge;
13 (C) the de-identified maximum negotiated charge;
14 (D) the discounted cash price; and
15 (E) the payer-specific negotiated charge, listed by the name of the
16 third-party payer and plan associated with the charge and displayed in a
17 manner that clearly associates the charge with each third-party payer
18 and plan; and
19 (iii) any code used by the facility for purposes of accounting or
20 billing for the facility item or service, including, but not limited to,
21 the Current Procedural Terminology (CPT) code, the Healthcare Common
22 Procedure Coding System (HCPCS) code, the Diagnosis Related Group (DRG)
23 code, the National Drug Code (NDC), or other common payer identifier.
24 (b) The standard charges contained in the list required to be main-
25 tained by a facility under paragraph (a) of this subdivision must
26 reflect the standard charges applicable to that location of the facili-
27 ty, regardless of whether the facility operates in more than one
28 location or operates under the same license or approval as another
29 facility.
30 (c) The information contained in the list required under paragraph (a)
31 of this subdivision must be published in a single digital file that is
32 in a machine-readable format.
33 (d) The list required under paragraph (a) of this subdivision must be
34 displayed in a prominent location on the home page of the facility's
35 publicly accessible internet website or accessible by selecting a dedi-
36 cated link that is prominently displayed on the home page of the facili-
37 ty's publicly accessible internet website. If the facility operates
38 multiple locations and maintains a single internet website, the list
39 required under paragraph (a) of this subdivision must be posted for each
40 location the facility operates in a manner that clearly associates the
41 list with the applicable location of the facility.
42 (e) The list required under paragraph (a) of this subdivision must:
43 (i) be available:
44 (A) free of charge;
45 (B) without having to register or establish a user account or pass-
46 word;
47 (C) without having to submit personal identifying information;
48 (D) without having to enter a code to access the list; and
49 (E) without having to overcome any other barrier that limits the
50 availability or accessibility of the list;
51 (ii) be accessible to a common commercial operator of an internet
52 search engine to the extent necessary for the search engine to index the
53 list and display the list as a result in response to a search query of a
54 user of the search engine;
55 (iii) be formatted in a manner prescribed by the department under
56 subdivision five of this section;
S. 7479 5
1 (iv) be digitally searchable; and
2 (v) use the following naming convention specified by the Centers for
3 Medicare and Medicaid Services, specifically: _
4 name>_standardcharges.{json/xml/csv}.
5 (f) The facility must update the list required under paragraph (a) of
6 this subdivision at least once a year. The facility must clearly indi-
7 cate the date on which the list was most recently updated, either within
8 the list itself or in a manner that is clearly associated with the list.
9 4. (a) Except as provided by paragraph (c) of this subdivision, a
10 facility shall maintain and make publicly available a list of the stand-
11 ard charges described in subparagraphs (i), (ii), (iii), (iv) and (v) of
12 paragraph (d) of this subdivision for at least three hundred shoppable
13 services provided by the facility. The facility may select the shoppable
14 services to be included in the list, except that the list must include:
15 (i) the seventy services specified as shoppable services by the
16 Centers for Medicare and Medicaid Services; or
17 (ii) if the facility does not provide all of the seventy services
18 specified as shoppable services by the Centers for Medicare and Medicaid
19 Services, as many of those shoppable services the facility does provide.
20 (b) In selecting a shoppable service for purposes of inclusion in the
21 list required under paragraph (a) of this subdivision, a facility must:
22 (i) consider how frequently the facility provides the service and the
23 facility's billing rate for that service; and
24 (ii) prioritize the selection of services that are among the services
25 most frequently provided by the facility.
26 (c) If a facility does not provide three hundred shoppable services,
27 the facility must maintain a list of all of the shoppable services that
28 the facility provides in a manner that otherwise complies with the
29 requirements of paragraph (a) of this subdivision.
30 (d) The list required under paragraph (a) or (c) of this subdivision,
31 as applicable, must include:
32 (i) a plain-language description of each shoppable service included on
33 the list;
34 (ii) the payer-specified negotiated charge that applies to each shop-
35 pable service included on the list, and any corresponding ancillary
36 service as applicable, listed by the name of the third-party payer and
37 plan associated with the charge and displayed in a manner that clearly
38 associates the charge with the third-party payer and plan;
39 (iii) the discounted cash price that applies to each shoppable service
40 included on the list, and any corresponding ancillary service as appli-
41 cable, or if the facility does not offer a discounted cash price for one
42 or more of the shoppable or ancillary services on the list, the gross
43 charge for the shoppable or ancillary service, as applicable;
44 (iv) the de-identified minimum negotiated charge that applies to each
45 shoppable service included on the list and any corresponding ancillary
46 service, as applicable;
47 (v) the de-identified maximum negotiated charge that applies to each
48 shoppable service included on the list and any corresponding ancillary
49 service, as applicable;
50 (vi) any code used by the facility for purposes of accounting or bill-
51 ing for each shoppable service included on the list and any ancillary
52 service, including the Current Procedural Terminology (CPT) code, the
53 Healthcare Common Procedure Coding System (HCPCS) code, the Diagnosis
54 Related Group (DRG) code, the National Drug Code (NDC), or other common
55 payer identifier;
S. 7479 6
1 (vii) each location at which the facility provides the shoppable
2 service and whether the standard charges identified in subparagraphs
3 (ii), (iii), (iv) and (v) of this paragraph apply at that location to
4 the provision of that shoppable service in an inpatient setting, an
5 outpatient department setting, or in both of those settings, as applica-
6 ble; and
7 (viii) if applicable, indicate if one of more of the shoppable
8 services specified by the Centers for Medicare and Medicaid Services is
9 not provided by the facility.
10 (e) The list required under paragraph (a) or (c) of this subdivision,
11 as applicable, must be displayed in a prominent location on the home
12 page of the facility's publicly accessible internet website or accessi-
13 ble by selecting a dedicated link that is prominently displayed on the
14 home page of the facility's publicly accessible internet website. If the
15 facility operates multiple locations and maintains a single internet
16 website, the list required under paragraph (a) or (c) of this subdivi-
17 sion, as applicable, must be posted for each location the facility oper-
18 ates in a manner that clearly associates the list with the applicable
19 location of the facility.
20 (f) The list required under paragraph (a) or (c) of this subdivision,
21 as applicable, must be:
22 (i) easily accessible and available:
23 (A) free of charge;
24 (B) without having to register or establish a user account or pass-
25 word;
26 (C) without having to submit personal identifying information;
27 (D) without having to enter a code to access the list; and
28 (E) without having to overcome any other barrier that limits the
29 availability or accessibility of the list; and
30 (ii) digitally searchable by service description, billing code, and
31 payer;
32 (iii) accessible to a common commercial operator of an internet search
33 engine to the extent necessary for the search engine to index the list
34 and display the list as a result in response to a search query of a user
35 of the search engine;
36 (iv) formatted in a manner that is consistent with the format
37 prescribed by the department under subdivision five of this section; and
38 (v) updated at least once a year. The facility must clearly indicate
39 the date on which the list was most recently updated, either within the
40 list itself or in a manner that is clearly associated with the list.
41 (g) Notwithstanding any other provision of this section, a facility is
42 considered to meet the requirements of this subdivision if the facility
43 maintains, as determined by the department, an internet-based price
44 estimator tool that meets the following requirements:
45 (i) provides a reasonably accurate cost estimate for each shoppable
46 service and any corresponding ancillary service included on the list
47 maintained by the facility under paragraph (a) or (c) of this subdivi-
48 sion, as applicable;
49 (ii) allows a person to obtain a reasonably accurate estimate of the
50 amount the person will be obligated to pay the facility if the person
51 elects to use the facility to provide the service; and
52 (iii) is prominently displayed on the facility's publicly accessible
53 internet website and is accessible to the public without charge and
54 without having to register or establish a user account or password.
55 5. In prescribing the format of the list under subparagraph (iii) of
56 paragraph (e) of subdivision three and subparagraph (iv) of paragraph
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1 (f) of subdivision four of this section, the department shall develop a
2 template that each facility must use in formatting the list, and in
3 developing this template, the department must:
4 (a) consider any applicable federal guidelines for formatting similar
5 lists required by federal law or regulation and ensure that the design
6 of the template enables healthcare researchers to compare the charges
7 contained in the lists maintained by each facility; and
8 (b) design the template to be substantially similar to the template
9 used by the Centers for Medicare and Medicaid Services for purposes
10 similar to those of this section, if the department determines that
11 designing the template in that manner serves the purposes of paragraph
12 (a) of this subdivision and that the department benefits from developing
13 and requiring that substantially similar design.
14 6. Each time a facility updates a list as required under paragraph (f)
15 of subdivision three and subparagraph (v) of paragraph (f) of subdivi-
16 sion four of this section, the facility shall submit the updated list to
17 the department. The department may prescribe the form in which the
18 updated list must be submitted to the department.
19 7. (a) The department shall monitor each facility's compliance with
20 the requirements of this section using, but not limited to, the follow-
21 ing methods:
22 (i) evaluating complaints made by individuals or entities to the
23 department, including through a complaint form on the department's
24 internet website;
25 (ii) reviewing any analysis prepared by individuals or entities
26 regarding noncompliance with this section;
27 (iii) auditing the internet websites of facilities for compliance with
28 this section; and
29 (iv) confirming that each facility submitted the lists required under
30 subdivision six of this section.
31 (b) If the department determines that any facility is not in compli-
32 ance with any provision of this section, the department may take any of
33 the following actions, without regard to the order of the actions:
34 (i) provide a written notice to the facility that clearly explains the
35 manner in which the facility is not in compliance with this section;
36 (ii) request a corrective action plan from the facility if the facili-
37 ty is in material noncompliance with this section, as determined under
38 subdivision eight of this section;
39 (iii) share information with government agencies, the Centers for
40 Medicare and Medicaid Services, or other entities as it deems appropri-
41 ate; and
42 (iv) impose an administrative penalty on the facility and publicize
43 the penalty on the commission's internet website if the facility fails
44 to respond to the department's request to submit a corrective action
45 plan or comply with the requirements of a corrective action plan submit-
46 ted to the department, pursuant to subdivision nine of this section.
47 8. (a) A facility is in material noncompliance with this section if
48 the facility fails to:
49 (i) comply with the requirements of subdivision two of this section;
50 or
51 (ii) publicize the facility's standard charges in the form and manner
52 required under subdivision three or four of this section.
53 (b) If the department determines that a facility is in material
54 noncompliance with this section, the department may issue a notice of
55 material noncompliance to the facility and request that the facility
56 submit a corrective action plan. The notice must indicate the form and
S. 7479 8
1 manner in which the corrective action plan must be submitted to the
2 department, and clearly state the date by which the facility must submit
3 the plan.
4 (c) A facility that receives a notice under paragraph (b) of this
5 subdivision must:
6 (i) submit a corrective action plan in the form and manner, and by the
7 specified date, prescribed by the notice of violation; and
8 (ii) as soon as practicable after submission of a corrective action
9 plan to the department, act to comply with the plan.
10 (d) A corrective action plan submitted to the department must:
11 (i) describe in detail the corrective action the facility will take to
12 address any violation identified by the department in the notice
13 provided under paragraph (b) of this subdivision; and
14 (ii) provide a date by which the facility will complete the corrective
15 action plan.
16 (e) A corrective action plan is subject to review and approval by the
17 department. After the department reviews and approves a facility's
18 corrective action plan, the department may monitor and evaluate the
19 facility's compliance with the plan.
20 (f) A facility is considered to have failed to respond to the depart-
21 ment's request to submit a corrective action plan if the facility fails
22 to submit a corrective action plan in the form and manner specified in
23 the notice under paragraph (b) of this subdivision or by the date speci-
24 fied in the notice under paragraph (b) of this subdivision.
25 (g) A facility is considered to have failed to comply with a correc-
26 tive action plan if the facility fails to address a violation within the
27 specified period of time contained in the plan.
28 (h) A facility that is in material noncompliance with this section
29 shall be placed onto a list of facilities in material noncompliance that
30 is published on the department's public internet website, except where:
31 (i) the facility in material noncompliance has submitted a corrective
32 action plan that has been approved by the department; and
33 (ii) the facility remains compliant with this section.
34 9. (a) The department may impose an administrative penalty on a facil-
35 ity if the facility fails to:
36 (i) respond to the department's request to submit a corrective action
37 plan; or
38 (ii) comply with the requirements of a corrective action plan submit-
39 ted to the department.
40 (b) The department may impose an administrative penalty on a facility
41 for a violation of each requirement of this section. The department
42 shall set the penalty in an amount sufficient to ensure compliance by
43 the facility with the provisions of this section subject to the limita-
44 tions in paragraph (c) of this subdivision.
45 (c) Using the most recently updated number of beds reported to the
46 Centers for Medicaid and Medicare Services, the department, or another
47 entity designated by the department, for each day a facility is deter-
48 mined by the department to be out of compliance, the daily civil mone-
49 tary penalty may not exceed:
50 (i) three hundred dollars for each day the facility violated this
51 section for a facility with a number of beds equal to or less than thir-
52 ty, even if the facility is in violation of multiple discrete require-
53 ments of this section;
54 (ii) the number of beds multiplied by ten dollars for each day the
55 facility violated this section for a facility with at least thirty-one
56 beds and up to and including five hundred fifty beds, even if the facil-
S. 7479 9
1 ity is in violation of multiple discrete requirements of this section;
2 or
3 (iii) five thousand dollars for each day the facility violated this
4 section for a facility with a number of beds greater than five hundred
5 fifty, even if the facility is in violation of multiple discrete
6 requirements of this section.
7 (d) Each day a violation continues is considered a separate violation.
8 (e) In determining the amount of the penalty, the department shall
9 consider:
10 (i) previous violations by the facility operator;
11 (ii) the seriousness of the violation;
12 (iii) the demonstrated good faith of the facility's operator; and
13 (iv) any other matters as justice may require.
14 (f) An administrative penalty collected under this section shall be
15 appropriated only to the department.
16 10. The department may prepare and submit a report of recommendations
17 for amending this section to the governor, the temporary president of
18 the senate, and the speaker of the assembly, including recommendations
19 in response to amendments by the Centers for Medicare and Medicaid
20 Services to 45 C.F.R. Part 180.
21 11. No facility shall enforce any clause mandating mediation or alter-
22 native dispute resolution in any facility document, including contracts,
23 agreements, statements, or bills, in an action arising from patient or
24 patient guarantor non-payment of facility items or services if that
25 facility is in material noncompliance with this section on the date that
26 the relevant facility items or services are purchased from a provider to
27 a patient by the facility in material noncompliance.
28 12. (a) If a patient believes that a facility was in material noncom-
29 pliance with this section on or after the date that the relevant items
30 or services are purchased by or provided to the patient, and the facili-
31 ty takes a collections action, as defined in this section, against the
32 patient or patient guarantor, and the patient or patient guarantor
33 believes that the material noncompliance is related to the relevant
34 facility item or service, the patient or patient guarantor may file suit
35 to determine if the facility was in material noncompliance with this
36 section. The facility shall not take a collections action against the
37 patient or patient guarantor related to the relevant facility item or
38 service, and must stay any related pending collections action against
39 the patient or patient guarantor, while the lawsuit is pending.
40 (b) A facility that has been found by a court to be in material
41 noncompliance with this section:
42 (i) shall refund the third-party payer any amount of the medical debt
43 the third-party payer has paid and shall pay a penalty to the patient or
44 patient guarantor in an amount equal to the total amount of the debt;
45 (ii) shall dismiss or cause to be dismissed any court action and
46 collections action with prejudice and pay any attorney fees and costs
47 incurred by the patient or patient guarantor relating to the action; and
48 (iii) remove or cause to be removed from the patient's or patient
49 guarantor's credit report any report made to a consumer reporting agency
50 relating to the debt.
51 13. Nothing in this section:
52 (a) prohibits a facility from billing a patient, patient guarantor, or
53 third-party payer, including health insurer, for items or services
54 provided to the patient; or
S. 7479 10
1 (b) requires a facility to refund any payment made to the hospital for
2 items or services provided to the patient, so long as no collection
3 action is taken in violation of this section.
4 § 5. This act shall take effect one year after it shall have become a
5 law.
