New Jersey

Statutory floor

New Jersey’s Charity Care program: typically 100% at or below 200% FPL and sliding discounts to 300% FPL, with documented New Jersey residency and screening. Hospitals must help patients apply. Credit-reporting limits apply to medical debts under $500; broader furnisher rules also exist.

N.J.A.C. 10:52 subch. 11–13 (Charity Care / Health Care Cost Reduction Act) · compiled September 2026

Rule	This state
Free-care floor	200% FPL
Discount / eligibility floor	300% FPL
Covers insured patients	Yes, if they otherwise qualify
Which hospitals	Generally all licensed hospitals
Medicaid expansion	Yes — adults to 138% FPL
Screen before collections	Yes
Credit reports	N.J. S2806 and related rules restrict reporting of medical debt under $500. Larger unpaid medical balances may still appear. Dispute both.
Debt sales	Not banned
Home liens	Not banned
Wage garnishment	Tighter than the federal 25% cap
Interest on medical debt	No special cap located
Collection hold	No extra state waiting period
Lawsuit clock	6 years · N.J.S.A. 2A:14-1

2026 poverty line here

Alaska and Hawaii use their own HHS tables. Everyone else uses the 48-state and D.C. figures, effective January 2026.

Household	100%	Free floor	Discount floor
1	$15,960	$31,920	$47,880
2	$21,640	$43,280	$64,920
3	$27,320	$54,640	$81,960
4	$33,000	$66,000	$99,000
5	$38,680	$77,360	$116,040
6	$44,360	$88,720	$133,080

What to do

01 Charity Care is a state program. Ask the hospital to submit the application, not to “see what they can do.”
02 200% FPL is typically free; 300% is the usual sliding cap. Bring ID and residency proof.
03 Itemize professional fees — they sometimes sit outside Charity Care.
04 Medical debt under $500 should not be on a New Jersey credit report.

Appeals

New Jersey surprise-billing law plus the No Surprises Act.

Insurance: New Jersey DOBI — IHCAP / external review

Medicaid: DMAHS fair hearing (NJ FamilyCare).

Medicare is federal regardless of state: redetermination, reconsideration, ALJ, Appeals Council, then district court.

Cite this in a letter

I request New Jersey Charity Care under N.J.A.C. 10:52 and a hospital FAP review. If household income is at or below 200% of FPL, please apply a 100% charity-care write-off; if at or below 300% of FPL, please apply the sliding-scale discount.

Put a New Jersey bill in the machine.

The estimate will use this state’s floors. The letters will cite N.J.A.C. 10:52 subch. 11–13 (Charity Care / Health Care Cost Reduction Act).

Start a New Jersey case

New Jersey Attorney General

Federal overlay — every state

501(r)
501(c)(3) hospital organizations must publish a Financial Assistance Policy, a plain-language summary, and generally may not take extraordinary collection actions (selling the debt, reporting it, liens, lawsuits) until they have made reasonable efforts to determine FAP eligibility.
No Surprises Act
Emergency services, air ambulance, and many out-of-network clinicians at in-network facilities cannot balance-bill beyond in-network cost-sharing. Independent dispute resolution is between the plan and the provider — not a reason to pay the sticker rate.
FDCPA
15 U.S.C. § 1692g. Within 30 days of first collector contact, demand validation. Until validated, collection and credit reporting should stop. Partial payment can restart a state’s statute of limitations.
EMTALA
Emergency departments must screen and stabilize regardless of ability to pay. An ER bill is not an agreement that chargemaster rates are the cash price.
Medicare appeals
Five levels: redetermination (MAC, 120 days), reconsideration (QIC), ALJ at OMHA, Medicare Appeals Council, then federal district court. A remaining patient balance is often a claim the provider still needs to work.
Credit bureaus
The CFPB’s 2025 medical-debt reporting rule was vacated in July 2025. Industry practice still generally omits paid medical collections and unpaid balances under $500. Unpaid medical debt over $500 can appear after a delay unless a state ban applies. FCRA-preemption fights over those state bans are ongoing.