<?xml version="1.0" encoding="ISO-8859-1"?><section number="31A-26-313"><effdate>5/14/2019</effdate><histories><history>Amended by Chapter <modchap sess="2019GS">321</modchap>, 2019 General Session</history><modyear>2019</modyear></histories><catchline>Health care collection actions -- Notification required.</catchline><subsection number="31A-26-313(1)">
As used in this section:
<subsection number="31A-26-313(1)(a)"><subsection number="31A-26-313(1)(a)(i)">
"Collection action" means any action taken to recover funds that are past due or accounts that are in default:
<subsection number="31A-26-313(1)(a)(i)(A)">
for health care services; and</subsection><subsection number="31A-26-313(1)(a)(i)(B)">
that directly results in an adverse report to a credit bureau.</subsection></subsection><subsection number="31A-26-313(1)(a)(ii)">
"Collection action" includes using the services of a collection agency to engage in collection action.</subsection><subsection number="31A-26-313(1)(a)(iii)">
"Collection action" does not include:
<subsection number="31A-26-313(1)(a)(iii)(A)">
billing or invoicing for funds that are not past due or accounts that are not in default; or</subsection><subsection number="31A-26-313(1)(a)(iii)(B)">
providing the notice required in this section.</subsection></subsection></subsection><subsection number="31A-26-313(1)(b)">
"Credit bureau" means a consumer reporting agency as defined in 15 U.S.C. Sec. 1681a.</subsection><subsection number="31A-26-313(1)(c)">
"Text message" means a real time or near real time message that consists of text and is transmitted to a device identified by a telephone number.</subsection></subsection><subsection number="31A-26-313(2)"><subsection number="31A-26-313(2)(a)">
Before engaging in a collection action, a health care provider:<subsection number="31A-26-313(2)(a)(i)">
shall, after the day on which the period of time for an insurer to pay or deny a claim without penalty, described in Section <xref depth="3" refnumber="31A-26-301.6" start="0">31A-26-301.6</xref>, expires, send a notice described in Subsection <xref depth="4" refnumber="31A-26-313(3)" start="0">(3)</xref> to the insured by certified mail with return receipt requested, priority mail, first class mail, email, or text message; and</subsection><subsection number="31A-26-313(2)(a)(ii)">
for a Medicare beneficiary or retiree 65 years of age or older, shall, after the date that Medicare determines Medicare's liability for the claim, send a notice described in Subsection <xref depth="4" refnumber="31A-26-313(3)" start="0">(3)</xref> to the insured by certified mail with return receipt requested, priority mail, first class mail, or text message.</subsection></subsection><subsection number="31A-26-313(2)(b)">
A health care provider may not engage in a collection action before the date described in Subsection <xref depth="4" refnumber="31A-26-313(3)(b)" start="0">(3)(b)</xref> for that collection action.</subsection></subsection><subsection number="31A-26-313(3)">
The notice described in Subsection <xref depth="4" refnumber="31A-26-313(2)(a)" start="0">(2)(a)</xref> shall state:
<subsection number="31A-26-313(3)(a)">
the amount that the insured owes;</subsection><subsection number="31A-26-313(3)(b)">
the date by which the insured must pay the amount owed that is:<subsection number="31A-26-313(3)(b)(i)">
at least 45 days after the day on which the health care provider sends the notice; or</subsection><subsection number="31A-26-313(3)(b)(ii)">
if the insured is a Medicare beneficiary or retiree 65 years of age or older, at least 60 days after the day on which the health care provider sends the notice;</subsection></subsection><subsection number="31A-26-313(3)(c)">
that if the insured fails to timely pay the amount owed, the health care provider or a third party may make a report to a credit bureau or use the services of a collection agency; and</subsection><subsection number="31A-26-313(3)(d)">
that each action described in Subsection <xref depth="4" refnumber="31A-26-313(3)(c)" start="0">(3)(c)</xref> may negatively impact the insured's credit score.</subsection></subsection><subsection number="31A-26-313(4)">
A health care provider is not subject to the requirements described in Subsection <xref depth="4" refnumber="31A-26-313(2)" start="0">(2)</xref> if the health care provider complies with the provisions of 26 C.F.R. Sec. 1.501(r)-6.</subsection><subsection number="31A-26-313(5)">
A health care provider that contracts with a third party to engage in a collection action is not subject to the requirements described in Subsection <xref depth="4" refnumber="31A-26-313(2)" start="0">(2)</xref> if:
<subsection number="31A-26-313(5)(a)">
entering into the contract does not require a report to a credit bureau by either the health care provider or the third party; and</subsection><subsection number="31A-26-313(5)(b)">
the third party agrees to provide the notice in accordance with Subsection <xref depth="4" refnumber="31A-26-313(2)" start="0">(2)</xref> before the third party may engage in any activity that directly results in a report to a credit bureau.</subsection></subsection><subsection number="31A-26-313(6)">
If a third party fails to comply with the notice requirements described in this section, the health care provider that renders the health care service is liable for any penalty resulting from the noncompliance of the third party.</subsection></section>
