Limitations on Charges, Billing, and Collections
Massachusetts law limits nonprofit and for-profit hospital collection practices as a condition of reimbursement from the Health Safety Net Trust Fund; Voluntary Guidelines recommend additional restrictions on nonprofit hospital billing and collection policies and practices.

As a condition of reimbursement from the Health Safety Net Trust Fund, hospitals may not seek legal execution against a low-income patient’s personal residence or motor vehicle without the express approval of the hospital’s Board of Trustees.

The Voluntary Guidelines recommend that all nonprofit hospitals develop written “Credit and Collection” policies that describe any program through which a hospital offers discounts for the uninsured or medically indigent, including the hospital’s charity care policies. The Voluntary Guidelines, (pp. 28-30) also recommend that all nonprofit hospitals refrain from:
Beginning collection activities before providing the patient a written statement of the availability of financial counseling services, and offering a patient facing financial hardship a reasonable payment plan;

Referring a patient’s account to a third-party collection agency before 120 days has passed after sending the first bill to the patient;

Executing a lien against a patient’s residence or automobile unless specifically approved by the hospital’s Board; and

Charging interest on patient debt.