asset_type: eligibility

body: 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Page one of a search for it is content-mill sites with no statutory citation, at least one of which states Washington's superseded rule as current.

key_field: state

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

title: State minimum standards for hospital financial assistance (charity care)

type: dataset


body:
**State:** California

**Statute:** HSC 127405

**Upper income level for discounted care:** at or below 400 percent of the federal poverty level

**Which hospitals must comply:** Each hospital shall maintain an understandable written policy regarding discount payments for financially qualified patients as well as an understandable written charity care policy

**Deadline to apply:** A 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.

**Basis for the income test:** federal poverty level

**Notes:** Rural 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.

> Uninsured patients or patients with high medical costs who are at or below 400 percent of the federal poverty level, as defined in subdivision (b) of Section 127400, shall be eligible for participation under a hospital’s charity care policy or discount payment policy.

Source: <https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC&sectionNum=127405>

income_basis: federal poverty level

state: California

title: California — State minimum standards for hospital financial assistance (charity care)

type: eligibility


body:
**State:** Colorado

**Statute:** 25.5-3-503

**Upper income level for discounted care:** NOT MORE THAN TWO HUNDRED FIFTY PERCENT OF THE FEDERAL
POVERTY LEVEL

**Which hospitals must comply:** A HEALTH-CARE FACILITY AND
A LICENSED HEALTH-CARE PROFESSIONAL SHALL, FOR EMERGENCY AND
OTHER NON-CICP HEALTH-CARE SERVICES

**Basis for the income test:** FEDERAL
POVERTY LEVEL

**Notes:** (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.

> BEGINNING JUNE 1, 2022, IF A PATIENT IS SCREENED PURSUANT TO SECTION 25.5-3-502 AND IS DETERMINED TO BE A QUALIFIED PATIENT, A HEALTH-CARE FACILITY AND A LICENSED HEALTH-CARE PROFESSIONAL SHALL, FOR EMERGENCY AND OTHER NON-CICP HEALTH-CARE SERVICES: (a) LIMIT THE AMOUNTS CHARGED TO NOT MORE THAN THE DISCOUNTED RATE ESTABLISHED IN STATE DEPARTMENT RULE PURSUANT TO SECTION 25.5-3-505 (2)(j);

Source: <https://leg.colorado.gov/sites/default/files/2021a_1198_signed.pdf>

income_basis: FEDERAL POVERTY LEVEL

state: Colorado

title: Colorado — State minimum standards for hospital financial assistance (charity care)


body:
**State:** Connecticut

**Statute:** Sec. 19a-673

**Upper income level for discounted care:** at or below two hundred fifty per cent of the poverty income guidelines

**Which hospitals must comply:** No 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.

**Basis for the income test:** poverty income guidelines

**Notes:** Each 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.

> “Uninsured patient” means any person who is liable for one or more hospital charges whose income is at or below two hundred fifty per cent of the poverty income guidelines who (A) has applied and been denied eligibility for any medical or health care coverage provided under the Medicaid program due to failure to satisfy income or other eligibility requirements, and (B) is not eligible for coverage for hospital services under the Medicare or CHAMPUS programs, or under any Medicaid or health insurance program of any other nation, state, territory or commonwealth, or under any other governmental or privately sponsored health or accident insurance or benefit program

Source: <https://www.cga.ct.gov/current/pub/chap_368z.htm#sec_19a-673>

income_basis: poverty income guidelines

state: Connecticut

title: Connecticut — State minimum standards for hospital financial assistance (charity care)


body:
**State:** Illinois

**Statute:** 210 ILCS 89/10

**Income level for free care:** not more than 200% of the federal poverty income guidelines

**Upper income level for discounted care:** not more than 600% of the federal poverty income guidelines

**Which hospitals must comply:** A hospital, other than a rural hospital or
 |
 | Critical Access Hospital

**Basis for the income test:** federal poverty income guidelines

**Notes:** (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.

> Critical Access Hospital, shall provide a discount from its charges to any uninsured patient who applies for a discount and has family income of not more than 600% of the federal poverty income guidelines for all medically necessary health care services exceeding $150 in any one inpatient admission or outpatient encounter. | | (2) A hospital, other than 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 $150 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 200% of the federal poverty income guidelines.

Source: <https://www.ilga.gov/legislation/ilcs/fulltext.asp?DocName=021000890K10>

income_basis: federal poverty income guidelines

state: Illinois

title: Illinois — State minimum standards for hospital financial assistance (charity care)


body:
**State:** Maine

**Statute:** Title 22, §1716-A

**Income level for free care:** equal to or less than 200% of the federal poverty level

**Which hospitals must comply:** A 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.

**Basis for the income test:** federal poverty level

**Notes:** In 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.

> A hospital shall provide free, medically necessary services for patients whose family income is equal to or less than 200% of the federal poverty level.

Source: <https://www.mainelegislature.org/legis/Statutes/22/title22sec1716-A.html>

state: Maine

title: Maine — State minimum standards for hospital financial assistance (charity care)


body:
**State:** Maryland

**Statute:** §19–214.1

**Income level for free care:** at or below 200% of the federal poverty level

**Upper income level for discounted care:** below 500% of the federal poverty level

**Required discounts by income band:** 1. 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%.

**Which hospitals must comply:** each acute care hospital and each chronic care hospital in the State under the jurisdiction of the Commission

**Deadline to apply:** within 240 days after the initial hospital bill is provided

**Basis for the income test:** federal poverty level

**Notes:** Subject 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.

> Free medically necessary care to patients with family income at or below 200% of the federal poverty level, calculated at the time of service or updated, as appropriate, to account for any change in financial circumstances of the patient that occurs within 240 days after the initial hospital bill is provided;

Source: <https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=ghg&section=19-214.1>

discount_threshold: below 500% of the federal poverty level

state: Maryland

title: Maryland — State minimum standards for hospital financial assistance (charity care)


body:
**State:** Nevada

**Statute:** NRS 439B.320

**Which hospitals must comply:** A hospital shall provide, without
charge, in each fiscal year, care for indigent inpatients

**Basis for the income test:** each county shall use the definition of “indigent” in NRS 439B.310

**Notes:** 4. 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.

> A hospital shall provide, without charge, in each fiscal year, care for indigent inpatients in an amount which represents 0.6 percent of its net revenue for the hospital’s preceding fiscal year.

Source: <https://www.leg.state.nv.us/nrs/nrs-439b.html>

state: Nevada

title: Nevada — State minimum standards for hospital financial assistance (charity care)


body:
**State:** New Jersey

**Statute:** N.J.A.C. 10:52-11.8

**Income level for free care:** less than or equal to 200 percent of the HHS Poverty Guidelines

**Upper income level for discounted care:** greater than 200 percent of the HHS Poverty Guidelines but not more than 300 percent of these guidelines

**Required discounts by income band:** Income 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

**Deadline to apply:** at any time up to one year from the date of outpatient service or inpatient discharge

**Basis for the income test:** HHS Poverty Guidelines

**Notes:** If 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.

> A person whose individual or, if applicable, family income, as determined by (e) below, is less than or equal to 200 percent of the HHS Poverty Guidelines shall be eligible for charity care for necessary health services without cost.

Source: <https://www.nj.gov/health/hcf/documents/charitycare/02-27-26-charity-care-section.pdf>

income_basis: HHS Poverty Guidelines

state: New Jersey

title: New Jersey — State minimum standards for hospital financial assistance (charity care)


body:
**State:** New Mexico

**Statute:** 13.10.39 NMAC

**Upper income level for discounted care:** less than or equal to two hundred percent of the federal poverty guidelines

**Which hospitals must comply:** This 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.

**Basis for the income test:** federal poverty guidelines

**Notes:** Collection 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.

> utilizing the most recent federal poverty guidelines, the patient household income and household size, the medical creditor or medical debt collector shall determine whether the patient’s income is less than or equal to two hundred percent of the federal poverty guidelines

Source: <https://www.srca.nm.gov/parts/title13/13.010.0039.html>

income_basis: federal poverty guidelines

state: New Mexico

title: New Mexico — State minimum standards for hospital financial assistance (charity care)


body:
**State:** New York

**Statute:** PBH § 2807-k

**Income level for free care:** below at least two hundred percent of the federal poverty
 level, the hospital shall waive all charges

**Upper income level for discounted care:** below at least four hundred
 percent of the federal poverty level

**Required discounts by income band:** (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)

**Which hospitals must comply:** general hospitals shall,
 effective for periods on and after January first, two thousand seven, establish financial
 aid policies and procedures

**Basis for the income test:** federal poverty level

**Notes:** A 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 issued

> Such reductions from charges for patients with incomes below at least four hundred percent of the federal poverty level shall result in a charge to such individuals that does not exceed the amount that would have been paid for the same services provided pursuant to title XIX of the federal social security act (medicaid), 1 and provided further that such amounts shall be adjusted according to income level as follows: (i) For patients with incomes below at least two hundred percent of the federal poverty level, the hospital shall waive all charges.

Source: <https://codes.findlaw.com/ny/public-health-law/pbh-sect-2807-k.html>

state: New York

statute_citation: PBH § 2807-k

title: New York — State minimum standards for hospital financial assistance (charity care)


body:
**State:** Ohio

**Statute:** Section 5168.14

**Income level for free care:** at or below the federal poverty line

**Which hospitals must comply:** Each hospital that receives funds distributed under sections 5168.01 to 5168.14 of the Revised Code

**Basis for the income test:** federal poverty line

**Notes:** The 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.

> Each hospital that receives funds distributed under sections 5168.01 to 5168.14 of the Revised Code shall provide, without charge to the individual, basic, medically necessary hospital-level services to individuals who are residents of this state, are not medicaid recipients, and whose income is at or below the federal poverty line.

Source: <https://codes.ohio.gov/ohio-revised-code/section-5168.14>

free_care_threshold: at or below the federal poverty line

income_basis: federal poverty line

state: Ohio

statute_citation: Section 5168.14

title: Ohio — State minimum standards for hospital financial assistance (charity care)


body:
**State:** Oregon

**Statute:** 442.614

**Income level for free care:** not more than 200 percent of the federal poverty
guidelines

**Upper income level for discounted care:** not more than 400 percent of the federal poverty guidelines

**Required discounts by income band:** (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;

**Which hospitals must comply:** A nonprofit hospital’s written
financial assistance policy described in ORS 442.610 must

**Deadline to apply:** Any time up
to 12 months after a patient pays for the services that the hospital provided.

**Basis for the income test:** federal poverty
guidelines

**Notes:** (b) Apply to all
of the hospital’s nonprofit affiliated clinics;

> (A) For a patient whose household income is not more than 200 percent of the federal poverty guidelines, by 100 percent; (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;

Source: <https://www.oregonlegislature.gov/bills_laws/ors/ors442.html>

state: Oregon

title: Oregon — State minimum standards for hospital financial assistance (charity care)


body:
**State:** Rhode Island

**Statute:** 216-RICR-40-10-23

**Income level for free care:** up to and including 200% of the Federal Poverty Levels (FPL)

**Upper income level for discounted care:** between 200% and up to and including 300% of the Federal Poverty Levels (FPLs)

**Which hospitals must comply:** Every licensed hospital shall be in full compliance with the following statewide standards for the provision of charity care

**Basis for the income test:** Federal Poverty Levels (FPL)

**Notes:** 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.

> Hospitals shall provide full charity care (i.e., a 100% discount) to patients/guarantors whose annual income is up to and including 200% of the Federal Poverty Levels (FPL), taking into consideration family unit size.

Source: <https://rules.sos.ri.gov/regulations/part/216-40-10-23>

income_basis: Federal Poverty Levels (FPL)

state: Rhode Island

title: Rhode Island — State minimum standards for hospital financial assistance (charity care)


body:
**State:** Washington

**Statute:** RCW 70.170.060

**Income level for free care:** not more than 200 percent of the federal poverty level

**Upper income level for discounted care:** between 251 and 300 percent of the federal poverty level

**Required discounts by income band:** (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.

**Which hospitals must comply:** For the purpose of providing charity care, each hospital shall develop, implement, and maintain a policy which shall enable indigent persons access to charity care

**Deadline to apply:** at the time of application for charity care if the application is made within two years of the time of service

**Basis for the income test:** federal poverty level

**Notes:** an 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.

> (b) At a minimum, a hospital not subject to (a) of this subsection shall grant charity care per the following guidelines: (i) All patients and their guarantors whose income is not more than 200 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 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.

Source: <https://app.leg.wa.gov/RCW/default.aspx?cite=70.170.060>

state: Washington

title: Washington — State minimum standards for hospital financial assistance (charity care)