Amd §§5201 & 7501, CPLR; amd §601, Gen Bus L; add §2833, 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
________________________________________________________________________
9711
IN SENATE
April 2, 2026
___________
Introduced by Sen. CLEARE -- 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-three of the public health law, that is in material
14 noncompliance with section twenty-eight hundred thirty-three of the
15 public health law on the date that the relevant facility items or
16 services are purchased from a provider to a patient by the facility in
17 material 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
26 claim with respect to which arbitration is sought is tenable, or other-
27 wise pass upon the merits of the dispute. No facility, as defined under
28 section twenty-eight hundred thirty-three of the public health law,
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD08384-02-6
S. 9711 2
1 shall enforce an arbitration agreement or clause in any facility docu-
2 ment, including contracts, agreements, statements, or bills, in an
3 action arising from patient or patient guarantor non-payment of facility
4 items or services, if that facility is in material noncompliance with
5 section twenty-eight hundred thirty-three of the public health law on
6 the date that the relevant facility items or services are purchased from
7 a provider to a patient by the facility in material noncompliance.
8 § 3. Section 601 of the general business law is amended by adding two
9 new subdivisions 13 and 14 to read as follows:
10 13. Attempt to collect a medical debt, or debt arising from nonpayment
11 of facility items and services, from a patient or patient guarantor by
12 referring the debt, directly or indirectly, to a debt collector or debt
13 collection agency if the principal creditor is a facility, as defined by
14 section twenty-eight hundred thirty-three of the public health law, or
15 an affiliate, that is in material noncompliance with section twenty-
16 eight hundred thirty-three of the public health law on the date that the
17 relevant facility items or services are purchased from a provider to a
18 patient by the facility; or
19 14. Disclose or cause to be disclosed information affecting the
20 debtor's reputation for credit worthiness, including to a consumer cred-
21 it reporting agency as defined in article twenty-five of this chapter,
22 if the principal creditor is a facility, as defined by section twenty-
23 eight hundred thirty-three of the public health law, or an affiliate,
24 that is in material noncompliance with section twenty-eight hundred
25 thirty-one of the public health law on the date that the relevant facil-
26 ity items or services are purchased from a provider to a patient by the
27 facility, and the action arose from patient or patient guarantor non-
28 payment of facility items or services.
29 § 4. The public health law is amended by adding a new section 2833 to
30 read as follows:
31 § 2833. The hospital price transparency act. 1. As used in this
32 section:
33 (a) "Ancillary service" means a facility item or service that a facil-
34 ity customarily provides as part of or in conjunction with a shoppable
35 primary service.
36 (b) "Chargemaster" means the list of all facility items and services
37 maintained by a facility for which the facility has established a
38 charge.
39 (c) "Collections action" includes any of the following actions taken
40 with respect to a debt for items and services that were purchased from
41 or provided to a patient by a facility:
42 (i) attempting to collect a debt from a patient or patient guarantor
43 by referring the debt, directly or indirectly, to a debt collector, a
44 collection agency, or other third-party retained by or on behalf of the
45 facility;
46 (ii) initiating a lawsuit against the patient or patient guarantor, or
47 enforcing an arbitration or mediation clause in any facility documents
48 including contracts, agreements, statements, or bills; or
49 (iii) directly or indirectly causing a report to be made to a consumer
50 reporting agency.
51 (d) "De-identified maximum negotiated charge" means the highest charge
52 that a facility has negotiated with all third-party payers for a facili-
53 ty item or service.
54 (e) "De-identified minimum negotiated charge" means the lowest charge
55 that a facility has negotiated with all third-party payers for a facili-
56 ty item or service.
S. 9711 3
1 (f) "Discounted cash price" means the charge that applies to an indi-
2 vidual who pays cash, or cash equivalent, for a facility item or
3 service.
4 (g) "Facility" includes the following:
5 (i) general hospitals as defined in section twenty-eight hundred one
6 of this article; and
7 (ii) any hospital, as defined in section twenty-eight hundred one of
8 this article, to which the department determines this section should
9 apply.
10 (h) "Gross charge" means the charge for a facility item or service
11 that is reflected on a facility's chargemaster, absent any discounts.
12 (i) "Facility items and services" and any variation of this phrase
13 means all items and services, including individual items and services
14 and service packages, that may be provided by a facility to a patient in
15 connection with an inpatient admission or an outpatient department visit
16 for which the facility has established a standard charge. This includes,
17 but is not limited to:
18 (i) supplies and procedures;
19 (ii) room and board;
20 (iii) use of the facility and other areas, the charges for which are
21 generally referred to as facility fees;
22 (iv) services of physicians and non-physician practitioners, employed
23 by the facility, the charges for which are generally referred to as
24 professional charges; and
25 (v) any other item or service for which a facility has established a
26 standard charge.
27 (j) "Machine-readable format" means a digital representation of data
28 or information in a file that can be imported or read into a computer
29 system for further processing, including .XML, .JSON, and .CSV formats.
30 (k) "Payer-specific negotiated charge" means the charge that a facili-
31 ty has negotiated with a third-party payer for a facility item or
32 service.
33 (l) "Service package" means an aggregation of individual facility
34 items and services into a single service with a single charge.
35 (m) "Shoppable service" means a service that may be scheduled by a
36 health care consumer in advance.
37 (n) "Standard charge" means the regular rate established by the facil-
38 ity for a facility item or service provided to a specific group of
39 paying patients. This term includes all of the following, as defined
40 under this section:
41 (i) the gross charge;
42 (ii) the payer-specific negotiated charge;
43 (iii) the de-identified minimum negotiated charge;
44 (iv) the de-identified maximum negotiated charge; and
45 (v) the discounted cash price.
46 (o) "Third-party payer" means an entity that is, by statute, contract,
47 or agreement, legally responsible for payment of a claim for a facility
48 item or service.
49 2. Notwithstanding any other law, a facility must make public the
50 following:
51 (a) a digital file in a machine-readable format that contains a list
52 of all standard charges for all facility items and services as provided
53 in subdivision three of this section; and
54 (b) a consumer-friendly list of standard charges for a limited set of
55 shoppable services as provided in subdivision three of this section.
S. 9711 4
1 3. (a) A facility shall maintain a list of all standard charges for
2 all facility items and services in accordance with this section. This
3 list must include, as applicable:
4 (i) a description of each facility item or service provided by the
5 facility; and
6 (ii) the following charges for each individual facility item or
7 service when provided in either an inpatient setting or an outpatient
8 department setting, as applicable:
9 (A) the gross charge;
10 (B) the de-identified minimum negotiated charge;
11 (C) the de-identified maximum negotiated charge;
12 (D) the discounted cash price; and
13 (E) the payer-specific negotiated charge, listed by the name of the
14 third-party payer and plan associated with the charge and displayed in a
15 manner that clearly associates the charge with each third-party payer
16 and plan; and
17 (iii) any code used by the facility for purposes of accounting or
18 billing for the facility item or service, including, but not limited to,
19 the Current Procedural Terminology (CPT) code, the Healthcare Common
20 Procedure Coding System (HCPCS) code, the Diagnosis Related Group (DRG)
21 code, the National Drug Code (NDC), or other common payer identifier.
22 (b) The standard charges contained in the list required to be main-
23 tained by a facility under paragraph (a) of this subdivision must
24 reflect the standard charges applicable to that location of the facili-
25 ty, regardless of whether the facility operates in more than one
26 location or operates under the same license or approval as another
27 facility.
28 (c) The information contained in the list required under paragraph (a)
29 of this subdivision must be published in a single digital file that is
30 in a machine-readable format.
31 (d) The list required under paragraph (a) of this subdivision must be
32 displayed in a prominent location on the home page of the facility's
33 publicly accessible internet website or accessible by selecting a dedi-
34 cated link that is prominently displayed on the home page of the facili-
35 ty's publicly accessible internet website. If the facility operates
36 multiple locations and maintains a single internet website, the list
37 required under paragraph (a) of this subdivision must be posted for each
38 location the facility operates in a manner that clearly associates the
39 list with the applicable location of the facility.
40 (e) The list required under paragraph (a) of this subdivision must:
41 (i) be available:
42 (A) free of charge;
43 (B) without having to register or establish a user account or pass-
44 word;
45 (C) without having to submit personal identifying information;
46 (D) without having to enter a code to access the list; and
47 (E) without having to overcome any other barrier that limits the
48 availability or accessibility of the list;
49 (ii) be accessible to a common commercial operator of an internet
50 search engine to the extent necessary for the search engine to index the
51 list and display the list as a result in response to a search query of a
52 user of the search engine;
53 (iii) be formatted in a manner prescribed by the department under
54 subdivision five of this section;
55 (iv) be digitally searchable; and
S. 9711 5
1 (v) use the following naming convention specified by the Centers for
2 Medicare and Medicaid Services, specifically: _
3 name>_standardcharges.{json/xml/csv}.
4 (f) The facility must update the list required under paragraph (a) of
5 this subdivision at least once a year. The facility must clearly indi-
6 cate the date on which the list was most recently updated, either within
7 the list itself or in a manner that is clearly associated with the list.
8 4. (a) Except as provided by paragraph (c) of this subdivision, a
9 facility shall maintain and make publicly available a list of the stand-
10 ard charges described in subparagraphs (i), (ii), (iii), (iv) and (v) of
11 paragraph (d) of this subdivision for at least three hundred shoppable
12 services provided by the facility. The facility may select the shoppable
13 services to be included in the list, except that the list must include:
14 (i) the seventy services specified as shoppable services by the
15 Centers for Medicare and Medicaid Services; or
16 (ii) if the facility does not provide all of the seventy services
17 specified as shoppable services by the Centers for Medicare and Medicaid
18 Services, as many of those shoppable services the facility does provide.
19 (b) In selecting a shoppable service for purposes of inclusion in the
20 list required under paragraph (a) of this subdivision, a facility must:
21 (i) consider how frequently the facility provides the service and the
22 facility's billing rate for that service; and
23 (ii) prioritize the selection of services that are among the services
24 most frequently provided by the facility.
25 (c) If a facility does not provide three hundred shoppable services,
26 the facility must maintain a list of all of the shoppable services that
27 the facility provides in a manner that otherwise complies with the
28 requirements of paragraph (a) of this subdivision.
29 (d) The list required under paragraph (a) or (c) of this subdivision,
30 as applicable, must include:
31 (i) a plain-language description of each shoppable service included on
32 the list;
33 (ii) the payer-specified negotiated charge that applies to each shop-
34 pable service included on the list, and any corresponding ancillary
35 service as applicable, listed by the name of the third-party payer and
36 plan associated with the charge and displayed in a manner that clearly
37 associates the charge with the third-party payer and plan;
38 (iii) the discounted cash price that applies to each shoppable service
39 included on the list, and any corresponding ancillary service as appli-
40 cable, or if the facility does not offer a discounted cash price for one
41 or more of the shoppable or ancillary services on the list, the gross
42 charge for the shoppable or ancillary service, as applicable;
43 (iv) the de-identified minimum negotiated charge that applies to each
44 shoppable service included on the list and any corresponding ancillary
45 service, as applicable;
46 (v) the de-identified maximum negotiated charge that applies to each
47 shoppable service included on the list and any corresponding ancillary
48 service, as applicable;
49 (vi) any code used by the facility for purposes of accounting or bill-
50 ing for each shoppable service included on the list and any ancillary
51 service, including the Current Procedural Terminology (CPT) code, the
52 Healthcare Common Procedure Coding System (HCPCS) code, the Diagnosis
53 Related Group (DRG) code, the National Drug Code (NDC), or other common
54 payer identifier;
55 (vii) each location at which the facility provides the shoppable
56 service and whether the standard charges identified in subparagraphs
S. 9711 6
1 (ii), (iii), (iv) and (v) of this paragraph apply at that location to
2 the provision of that shoppable service in an inpatient setting, an
3 outpatient department setting, or in both of those settings, as applica-
4 ble; and
5 (viii) if applicable, indicate if one of more of the shoppable
6 services specified by the Centers for Medicare and Medicaid Services is
7 not provided by the facility.
8 (e) The list required under paragraph (a) or (c) of this subdivision,
9 as applicable, must be displayed in a prominent location on the home
10 page of the facility's publicly accessible internet website or accessi-
11 ble by selecting a dedicated link that is prominently displayed on the
12 home page of the facility's publicly accessible internet website. If the
13 facility operates multiple locations and maintains a single internet
14 website, the list required under paragraph (a) or (c) of this subdivi-
15 sion, as applicable, must be posted for each location the facility oper-
16 ates in a manner that clearly associates the list with the applicable
17 location of the facility.
18 (f) The list required under paragraph (a) or (c) of this subdivision,
19 as applicable, must be:
20 (i) easily accessible and available:
21 (A) free of charge;
22 (B) without having to register or establish a user account or pass-
23 word;
24 (C) without having to submit personal identifying information;
25 (D) without having to enter a code to access the list; and
26 (E) without having to overcome any other barrier that limits the
27 availability or accessibility of the list; and
28 (ii) digitally searchable by service description, billing code, and
29 payer;
30 (iii) accessible to a common commercial operator of an internet search
31 engine to the extent necessary for the search engine to index the list
32 and display the list as a result in response to a search query of a user
33 of the search engine;
34 (iv) formatted in a manner that is consistent with the format
35 prescribed by the department under subdivision five of this section; and
36 (v) updated at least once a year. The facility must clearly indicate
37 the date on which the list was most recently updated, either within the
38 list itself or in a manner that is clearly associated with the list.
39 (g) Notwithstanding any other provision of this section, a facility is
40 considered to meet the requirements of this subdivision if the facility
41 maintains, as determined by the department, an internet-based price
42 estimator tool that meets the following requirements:
43 (i) provides a reasonably accurate cost estimate for each shoppable
44 service and any corresponding ancillary service included on the list
45 maintained by the facility under paragraph (a) or (c) of this subdivi-
46 sion, as applicable;
47 (ii) allows a person to obtain a reasonably accurate estimate of the
48 amount the person will be obligated to pay the facility if the person
49 elects to use the facility to provide the service; and
50 (iii) is prominently displayed on the facility's publicly accessible
51 internet website and is accessible to the public without charge and
52 without having to register or establish a user account or password.
53 5. In prescribing the format of the list under subparagraph (iii) of
54 paragraph (e) of subdivision three and subparagraph (iv) of paragraph
55 (f) of subdivision four of this section, the department shall develop a
S. 9711 7
1 template that each facility must use in formatting the list, and in
2 developing this template, the department must:
3 (a) consider any applicable federal guidelines for formatting similar
4 lists required by federal law or regulation and ensure that the design
5 of the template enables healthcare researchers to compare the charges
6 contained in the lists maintained by each facility; and
7 (b) design the template to be substantially similar to the template
8 used by the Centers for Medicare and Medicaid Services for purposes
9 similar to those of this section, if the department determines that
10 designing the template in that manner serves the purposes of paragraph
11 (a) of this subdivision and that the department benefits from developing
12 and requiring that substantially similar design.
13 6. Each time a facility updates a list as required under paragraph (f)
14 of subdivision three and subparagraph (v) of paragraph (f) of subdivi-
15 sion four of this section, the facility shall submit the updated list to
16 the department. The department may prescribe the form in which the
17 updated list must be submitted to the department.
18 7. (a) The department shall monitor each facility's compliance with
19 the requirements of this section using, but not limited to, the follow-
20 ing methods:
21 (i) evaluating complaints made by individuals or entities to the
22 department, including through a complaint form on the department's
23 internet website;
24 (ii) reviewing any analysis prepared by individuals or entities
25 regarding noncompliance with this section;
26 (iii) auditing the internet websites of facilities for compliance with
27 this section; and
28 (iv) confirming that each facility submitted the lists required under
29 subdivision six of this section.
30 (b) If the department determines that any facility is not in compli-
31 ance with any provision of this section, the department may take any of
32 the following actions, without regard to the order of the actions:
33 (i) provide a written notice to the facility that clearly explains the
34 manner in which the facility is not in compliance with this section;
35 (ii) request a corrective action plan from the facility if the facili-
36 ty is in material noncompliance with this section, as determined under
37 subdivision eight of this section;
38 (iii) share information with government agencies, the Centers for
39 Medicare and Medicaid Services, or other entities as it deems appropri-
40 ate; and
41 (iv) impose an administrative penalty on the facility and publicize
42 the penalty on the commission's internet website if the facility fails
43 to respond to the department's request to submit a corrective action
44 plan or comply with the requirements of a corrective action plan submit-
45 ted to the department, pursuant to subdivision nine of this section.
46 8. (a) A facility is in material noncompliance with this section if
47 the facility fails to:
48 (i) comply with the requirements of subdivision two of this section;
49 or
50 (ii) publicize the facility's standard charges in the form and manner
51 required under subdivision three or four of this section.
52 (b) If the department determines that a facility is in material
53 noncompliance with this section, the department may issue a notice of
54 material noncompliance to the facility and request that the facility
55 submit a corrective action plan. The notice must indicate the form and
56 manner in which the corrective action plan must be submitted to the
S. 9711 8
1 department, and clearly state the date by which the facility must submit
2 the plan.
3 (c) A facility that receives a notice under paragraph (b) of this
4 subdivision must:
5 (i) submit a corrective action plan in the form and manner, and by the
6 specified date, prescribed by the notice of violation; and
7 (ii) as soon as practicable after submission of a corrective action
8 plan to the department, act to comply with the plan.
9 (d) A corrective action plan submitted to the department must:
10 (i) describe in detail the corrective action the facility will take to
11 address any violation identified by the department in the notice
12 provided under paragraph (b) of this subdivision; and
13 (ii) provide a date by which the facility will complete the corrective
14 action plan.
15 (e) A corrective action plan is subject to review and approval by the
16 department. After the department reviews and approves a facility's
17 corrective action plan, the department may monitor and evaluate the
18 facility's compliance with the plan.
19 (f) A facility is considered to have failed to respond to the depart-
20 ment's request to submit a corrective action plan if the facility fails
21 to submit a corrective action plan in the form and manner specified in
22 the notice under paragraph (b) of this subdivision or by the date speci-
23 fied in the notice under paragraph (b) of this subdivision.
24 (g) A facility is considered to have failed to comply with a correc-
25 tive action plan if the facility fails to address a violation within the
26 specified period of time contained in the plan.
27 (h) A facility that is in material noncompliance with this section
28 shall be placed onto a list of facilities in material noncompliance that
29 is published on the department's public internet website, except where:
30 (i) the facility in material noncompliance has submitted a corrective
31 action plan that has been approved by the department; and
32 (ii) the facility remains compliant with this section.
33 9. (a) The department may impose an administrative penalty on a facil-
34 ity if the facility fails to:
35 (i) respond to the department's request to submit a corrective action
36 plan; or
37 (ii) comply with the requirements of a corrective action plan submit-
38 ted to the department.
39 (b) The department may impose an administrative penalty on a facility
40 for a violation of each requirement of this section. The department
41 shall set the penalty in an amount sufficient to ensure compliance by
42 the facility with the provisions of this section subject to the limita-
43 tions in paragraph (c) of this subdivision.
44 (c) Using the most recently updated number of beds reported to the
45 Centers for Medicaid and Medicare Services, the department, or another
46 entity designated by the department, for each day a facility is deter-
47 mined by the department to be out of compliance, the daily civil mone-
48 tary penalty may not exceed:
49 (i) three hundred dollars for each day the facility violated this
50 section for a facility with a number of beds equal to or less than thir-
51 ty, even if the facility is in violation of multiple discrete require-
52 ments of this section;
53 (ii) the number of beds multiplied by ten dollars for each day the
54 facility violated this section for a facility with at least thirty-one
55 beds and up to and including five hundred fifty beds, even if the facil-
S. 9711 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. 9711 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.
