Reference Source

State minimum standards for hospital financial assistance (charity care)

The income floor a US state's own law forces hospitals to meet before they may bill a patient — stated as a percentage of the federal poverty level, taken one state at a time from that state's statute, never from a compilation. Federal law (IRS section 501(r)) makes every nonprofit hospital publish a financial assistance policy but sets no income threshold at all, so the only enforceable number is the one the state writes down, and roughly half the states write none. Where a state does set one it is genuinely different everywhere: Connecticut sets no free-care line at all but forbids a hospital collecting more than its own cost from an uninsured patient at or below 250% of the poverty income guidelines; California a single 400% line; Oregon free below 200% then a statutory sliding scale to 400%; Maryland free below 200% with six named discount bands running to 500% on financial hardship; Washington 300% free for hospitals in large health systems and 200% for the rest, which replaced a flat 200%/400% rule in 2022 and is still published the old way on most consumer sites. Each record also carries the deadline to apply, which is its own fifty-one-way fragment and the single most consequential thing here — Maryland allows a change of circumstances within 240 days of the first bill, Washington allows an application within two years of the date of service, and federal 501(r) sets 240 days for nonprofit hospitals only. Missing that window is how an unpayable bill becomes a collection account and then a credit event. Answers 'does my state make hospitals give free care and at what income', 'what is the charity care income limit in [state]', 'how long do I have to apply for hospital financial assistance in [state]', 'does my state's rule apply to a for-profit hospital', and 'is the Washington charity care limit 200% or 300%' (both — it depends on the hospital, since 2022). No federal agency publishes this; the one national assembly, a 2021 National Consumer Law Center report, is five years old and its URL now returns 404 at the address KFF still cites, and the Community Catalyst state pages that used to hold it are gone. Page one of a search for it is content-mill sites with no statutory citation, at least one of which states Washington's superseded rule as current.

Records14
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LicenceFacts extracted from state statutes and legislative websites; statutory text is not copyrightable and each record links to and quotes its own source section

The data

StateStatuteHighest income the rule still protectsWhich hospitals must complyDeadline to applyBasis for the income testNotesIncome level for free careRequired discounts by income band
CaliforniaHSC 127405at or below 400 percent of the federal poverty levelEach hospital shall maintain an understandable written policy regarding discount payments for financially qualified patients as well as an understandable written charity care policyA hospital shall not impose time limits for applying for charity care or discounted payments, nor deny eligibility based on the timing of a patient’s application.federal poverty levelRural hospitals, as defined in Section 124840, may establish eligibility levels for financial assistance and charity care at less than 400 percent of the federal poverty level as appropriate to maintain their financial and operational integrity.
Colorado25.5-3-503NOT MORE THAN TWO HUNDRED FIFTY PERCENT OF THE FEDERAL POVERTY LEVELA HEALTH-CARE FACILITY AND A LICENSED HEALTH-CARE PROFESSIONAL SHALL, FOR EMERGENCY AND OTHER NON-CICP HEALTH-CARE SERVICESFEDERAL POVERTY LEVEL(c) AFTER A CUMULATIVE THIRTY-SIX MONTHS OF PAYMENTS, CONSIDER THE PATIENT'S BILL PAID IN FULL AND PERMANENTLY CEASE ANY AND ALL COLLECTION ACTIVITIES ON ANY BALANCE THAT REMAINS UNPAID.
ConnecticutSec. 19a-673at or below two hundred fifty per cent of the poverty income guidelinesNo hospital or entity that is owned by or affiliated with such hospital that has provided health care to an uninsured patient may collect from the uninsured patient more than the cost of providing such health care.poverty income guidelinesEach collection agent engaged in collecting a debt from a patient arising from health care provided at a hospital shall provide written notice to such patient as to whether the hospital deems the patient an insured patient or uninsured patient and the reasons for such determination.
Illinois210 ILCS 89/10not more than 600% of the federal poverty income guidelinesA hospital, other than a rural hospital or | | Critical Access Hospitalfederal poverty income guidelines(3) A rural hospital or Critical Access Hospital | | shall provide a discount from its charges to any uninsured patient who applies for a discount and has annual family income of not more than 300% of the federal poverty income guidelines for all medically necessary health care services exceeding $300 in any one inpatient admission or outpatient encounter. | | (4) A rural hospital or Critical Access Hospital | | shall provide a charitable discount of 100% of its charges for all medically necessary health care services exceeding $300 in any one inpatient admission or outpatient encounter to any uninsured patient who applies for a discount and has family income of not more than 125% of the federal poverty income guidelines.not more than 200% of the federal poverty income guidelines
MaineTitle 22, §1716-AA hospital shall, in accordance with rules adopted by the department, provide free health care services to eligible patients who are state residents in accordance with this section.federal poverty levelIn accordance with rules adopted by the department, a hospital shall offer a patient with a documented family income that does not exceed 400% of the federal poverty level a payment plan that requires monthly out-of-pocket payments that do not exceed 4% of the patient's monthly family income that is not exempt from attachment or garnishment under state law.equal to or less than 200% of the federal poverty level
Maryland§19–214.1below 500% of the federal poverty leveleach acute care hospital and each chronic care hospital in the State under the jurisdiction of the Commissionwithin 240 days after the initial hospital bill is providedfederal poverty levelSubject to income thresholds set under paragraph (3) of this subsection, the financial assistance policy required under this subsection shall provide reduced–cost medically necessary care to patients with family income below 500% of the federal poverty level who have a financial hardship.at or below 200% of the federal poverty level1. For a patient with family income of at least 201% but not more than 250% of the federal poverty level, by 75%; 2. For a patient with family income of more than 250% but not more than 300% of the federal poverty level, by 60%; 3. For a patient with family income of more than 300% but not more than 350% of the federal poverty level, by 50%; 4. For a patient with family income of more than 350% but not more than 400% of the federal poverty level, by 45%; 5. For a patient with family income of more than 400% but not more than 450% of the federal poverty level, by 40%; and 6. For a patient with family income of more than 450% but not more than 500% of the federal poverty level, by 35%.
NevadaNRS 439B.320A hospital shall provide, without charge, in each fiscal year, care for indigent inpatientseach county shall use the definition of “indigent” in NRS 439B.3104. Whose income is less than: (a) For one person living without another member of a household, $438. (b) For two persons, $588. (c) For three or more persons, $588 plus $150 for each person in the family in excess of two.
New JerseyN.J.A.C. 10:52-11.8greater than 200 percent of the HHS Poverty Guidelines but not more than 300 percent of these guidelinesat any time up to one year from the date of outpatient service or inpatient dischargeHHS Poverty GuidelinesIf qualified medical expenses, as defined for the purposes of Federal income tax deductibility, for applicants eligible for reduced charge charity care exceeds 30 percent of the applicant's or family's, if applicable, annual gross income as calculated by (e) below, such excess will be eligible for 100 percent coverage under charity care.less than or equal to 200 percent of the HHS Poverty GuidelinesIncome as a percentage of HHS Poverty Guidelines Percentage of Charges Paid by Applicant >200 to 225 20 >225 to 250 40 >250 to 275 60 >275 to 300 80
New Mexico13.10.39 NMACless than or equal to two hundred percent of the federal poverty guidelinesThis rule applies to health care facilities, third-party health care providers, medical creditors, medical debt collectors and medical debt buyers subject to Sections 57-32-1 to 57-32-10 NMSA 1978.federal poverty guidelinesCollection action based on charges for health care services and medical debt may not be pursued against an indigent patient. A determination whether a patient is an indigent patient shall be made before collection action is pursued against the patient.
New YorkPBH § 2807-kbelow at least four hundred percent of the federal poverty levelgeneral hospitals shall, effective for periods on and after January first, two thousand seven, establish financial aid policies and proceduresfederal poverty levelA hospital or its collection agent shall not commence a civil action against a patient or delegate a collection activity to a debt collector for nonpayment for at least one hundred eighty days after the first post-service bill is issuedbelow at least two hundred percent of the federal poverty level, the hospital shall waive all charges(ii) For patients with incomes between at least two hundred percent and up to three hundred percent of the federal poverty level, the hospital shall collect no more than the amount identified after application of a proportional sliding fee schedule under which patients with lower incomes shall pay the lowest amount. Such schedule shall provide that the amount the hospital may collect for such patients increases in equal increments as the income of the patient increases, up to a maximum of ten percent of the amount that would have been paid for the same services provided pursuant to title XIX of the federal social security act (medicaid), or for underinsured patients, up to a maximum of ten percent of the amount that would have been paid pursuant to such patient's insurance cost sharing; (iii) For patients with incomes between at least three hundred one percent and four hundred percent of the federal poverty level, the hospital shall collect no more than the amount identified after application of a proportional sliding fee schedule under which patients with lower income shall pay the lowest amounts. Such schedule shall provide that the amount the hospital may collect for such patients increases from the ten percent figure described in subparagraph (ii) of this paragraph in equal increments as the income of the patient increases, up to a maximum of twenty percent of the amount that would have been paid for the same services provided pursuant to title XIX of the federal social security act (medicaid)
OhioSection 5168.14Each hospital that receives funds distributed under sections 5168.01 to 5168.14 of the Revised Codefederal poverty lineThe hospital has an established post-billing procedure for determining the individual's income and canceling the charges if the individual is found to qualify for services under this section.at or below the federal poverty line
Oregon442.614not more than 400 percent of the federal poverty guidelinesA nonprofit hospital’s written financial assistance policy described in ORS 442.610 mustAny time up to 12 months after a patient pays for the services that the hospital provided.federal poverty guidelines(b) Apply to all of the hospital’s nonprofit affiliated clinics;not more than 200 percent of the federal poverty guidelines(B) For a patient whose household income is more than 200 percent of the federal poverty guidelines and not more than 300 percent of the federal poverty guidelines, by a minimum of 75 percent; (C) For a patient whose household income is more than 300 percent of the federal poverty guidelines and not more than 350 percent of the federal poverty guidelines, by a minimum of 50 percent; and (D) For a patient whose household income is more than 350 percent of the federal poverty guidelines and not more than 400 percent of the federal poverty guidelines, by a minimum of 25 percent;
Rhode Island216-RICR-40-10-23between 200% and up to and including 300% of the Federal Poverty Levels (FPLs)Every licensed hospital shall be in full compliance with the following statewide standards for the provision of charity careFederal Poverty Levels (FPL)This partial charity care shall be on a sliding scale discount basis determined by each individual hospital pursuant to its own evaluation of its service area needs and financial resources.up to and including 200% of the Federal Poverty Levels (FPL)
WashingtonRCW 70.170.060between 251 and 300 percent of the federal poverty levelFor the purpose of providing charity care, each hospital shall develop, implement, and maintain a policy which shall enable indigent persons access to charity careat the time of application for charity care if the application is made within two years of the time of servicefederal poverty levelan acute care hospital with over 300 licensed beds located in the most populous county in Washington, or an acute care hospital with over 200 licensed beds located in a county with at least 450,000 residents and located on Washington's southern border shall grant charity care per the following guidelines: (i) All patients and their guarantors whose income is not more than 300 percent of the federal poverty level, adjusted for family size, shall be deemed charity care patients for the full amount of the patient responsibility portion of their hospital charges; (ii) All patients and their guarantors whose income is between 301 and 350 percent of the federal poverty level, adjusted for family size, shall be entitled to a 75 percent discount for the full amount of the patient responsibility portion of their hospital charges, which may be reduced by amounts reasonably related to assets considered pursuant to (c) of this subsection; (iii) All patients and their guarantors whose income is between 351 and 400 percent of the federal poverty level, adjusted for family size, shall be entitled to a 50 percent discount for the full amount of the patient responsibility portion of their hospital charges, which may be reduced by amounts reasonably related to assets considered pursuant to (c) of this subsection.not more than 200 percent of the federal poverty level(ii) All patients and their guarantors whose income is between 201 and 250 percent of the federal poverty level, adjusted for family size, shall be entitled to a 75 percent discount for the full amount of the patient responsibility portion of their hospital charges, which may be reduced by amounts reasonably related to assets considered pursuant to (c) of this subsection; and (iii) All patients and their guarantors whose income is between 251 and 300 percent of the federal poverty level, adjusted for family size, shall be entitled to a 50 percent discount for the full amount of the patient responsibility portion of their hospital charges, which may be reduced by amounts reasonably related to assets considered pursuant to (c) of this subsection.

Where this came from

Every record above links the page it was taken from and quotes the sentence that states it. These are the 14 sources this dataset was assembled from.

Machine-readable

From your own code

Same records, same quotes, without scraping the page: refsource is on PyPI and npm. Each value comes back carrying the URL it was read from and the sentence on that page that states it — .source and .quote sit on the value itself rather than in a side channel, so the checking step is available instead of skipped.

pip install refsource
refsource lookup state-hospital-financial-assistance-thresholds state=California

npx -y refsource lookup state-hospital-financial-assistance-thresholds state=California

14 records. last verified against source . due for re-check by .

Licence. Facts extracted from state statutes and legislative websites; statutory text is not copyrightable and each record links to and quotes its own source section