Hospital Fair Billing Program

Hospital Fair Billing Program Laws & Regulations

Assembly Bill (AB) 1020

On January 1, 2024, the Hospital Fair Billing Program (formerly known as the Fair Pricing Policies Program) assumed enforcement of the Hospital Fair Pricing Act from the California Department of Public Health. AB 1020 (Chapter 473, Statutes of 2021) expanded current notice and reporting requirements, established a patient complaint process, and authorized the assessment of administrative penalties against hospitals for violations of the Hospital Fair Pricing Act.

AB 1020 also created the following new requirements:

  • Raises the income level for financial assistance from 350 percent of the Federal Poverty Level (FPL) to 400 percent.
  • Prohibits hospitals from selling patient debt unless specified conditions are met, including that the hospital has found the patient ineligible for financial assistance or the patient has not responded to attempts to bill or offer financial assistance for 180 days.
  • Extends adverse credit reporting and commencement of civil action from 150 to 180 days after initial billing.
  • Requires debt collectors to certify that the patient has been screened for public health coverage programs and financial assistance before filing a lawsuit.

AB 2297 and Senate Bill (SB) 1061

On January 1, 2025, AB 2297 (Chapter 511, Statutes of 2024) and SB 1061 (Chapter 520, Statutes of 2024), went into effect. The new laws clarify existing requirements of the Hospital Fair Pricing Act and add additional patient protections.

AB 2297 and SB 1061:

  • Defines “charity care” and “discount payment,” and expands the definition of “patient’s family.”
  • Expands the Hospital Fair Billing Program’s authority to include violations that occurred on or after January 1, 2022.
  • Eliminates the consideration of monetary assets for any eligibility determination.
  • Prohibits requiring patients to apply for other coverage before discounted payment will be provided.
  • Allows hospitals to consider health savings accounts when negotiating payment plans.
  • Clarifies how third-party payments made directly to patients are applied.
  • Allows hospitals to consider other forms of documentation of income when income tax returns or paystubs are not available.
  • Clarifies that application deadlines are prohibited.
  • Prohibits liens or sale of any real property owned by the patient.
  • Prohibits adverse credit reporting.
  • Adds limitations for when a patient does not have to be reimbursed.

History of Fair Pricing Policies Legislation

AB 774 (Chapter 755, Statutes of 2006) established Hospital Fair Pricing Policies effective January 1, 2007. This legislation required each licensed general acute care hospital, psychiatric acute hospital, and special hospital to increase public awareness of the availability of charity care, payment discounts, government-sponsored health insurance, and to standardize its billing and collections procedures.

Assembly Bill 774 required HCAI to collect and make available to the public a copy of each hospital’s charity care and discount payment policies, eligibility procedures for those policies, review processes, and application forms.

Laws and Regulations

Mailing List

To receive informational updates about the program, subscribe to the HFBP mailing lists:

  • Notice of Regulatory Actions: Hospital Fair Billing Program (HFBP)
  • Public Meeting Notices: Hospital Fair Billing Program Meetings
Go to the subscription signup page