These are the legal provisions related to hospital financial assistance/charity care in the state of Maine. This is intended for educational use and should not be treated as legal advice.
Is there a state charity care law?
Yes, Maine has its own law.
Qualifications for charity care in Maine
Does the law specify a minimum Federal Poverty Level (FPL) for charity care?
Maine law specifies the minimum at 150% of the Federal Poverty Level.
Does the law specify a minimum deadline for applying for charity care?
Maine law specifies the minimum at 240 days from the first post-discharge bill.
Does the law specify that having insurance disqualifies a patient for charity care?
Maine law explicitly requires hospitals to provide assistance to the insured.
Does the law specify that patients must be residents to be eligible for charity care?
Maine law requires a patient to be a Maine resident to receive charity care under its state law.
Does the law specify that patients must be US citizens or documented immigrants/lawful permanent residents to be eligible for charity care?
Maine law does not address this matter, so federal law would apply.
Federal law does not directly answer this. However, we think that federal law prohibits nonprofit hospitals from denying patients charity care because of their immigration status.
Does the law specify that patients must owe a minimum bill amount in order to be eligible for charity care?
Maine law does not address this matter, so federal law would apply.
Federal law says that non-profit hospitals may not require a minimum bill amount for a patient to qualify for charity care. All emergency and medically necessary care conducted at a non-profit hospital is eligible for charity care.
How the law applies to copays in Maine
Does the law specify that patients cannot be responsible for a copay if they are eligible for charity care?
Maine prohibits requiring a copay for emergency services.
Does the law specify that hospitals cannot deny financial assistance to cover patient copays, coinsurance, or deductibles?
Maine prohibits requiring a copay for emergency services.
Collections laws related to charity care in Maine
Does the law specify that hospitals cannot deny financial assistance to cover patient copays, coinsurance, or deductibles?
Individuals eligible for chairty care, defined as at or belo 150% FPL, may not have their bills sent to collections. For those individuals over 150% FPL receiving services from a non-profit hospital, federal law mandates the nonprofit hospital wait at least 120 days after they sent the first post-discharge bill before sending the bill to collections.
Length of time charity care can be applied to future bills in Maine
Does the law specify that hospitals must honor a charity care decision for future bills for a specific length of time?
Maine law states that Approval lasts for at least six months for outpatient services.