New Jersey

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.

What to do

1. 01 Charity Care is a state program. Ask the hospital to submit the application, not to “see what they can do.”
2. 02 200% FPL is typically free; 300% is the usual sliding cap. Bring ID and residency proof.
3. 03 Itemize professional fees — they sometimes sit outside Charity Care.
4. 04 Medical debt for care since July 22, 2024 should not be on a New Jersey credit report, and paid or under-$500 medical debt never should.

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.

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.

  Official source

• 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.

  Official source

• FDCPA

  15 U.S.C. § 1692g. Within 30 days of first collector contact, demand validation. Until it is validated, the collector should stop collecting. Partial payment can restart a state’s statute of limitations.

  Official source

• 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.

  Official source

• 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.

  Official source

• 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.

  Official source

Sources

Official government sources for the New Jersey information on this page. UNDUE does not represent any government entity.

• N.J.A.C. 10:52 subch. 11-13 (Charity Care regulations, NJ Dept of Health PDF)
• NJ Dept of Health, Charity Care regulations and public notices
• P.L. 2024, c.48 (Louisa Carman Medical Debt Relief Act, C.56:11-56 et seq.: credit reporting, 3% interest cap, wage garnishment, 120-day hold)
• N.J.S.A. 2A:14-1 (lawsuit clock, 6 years)
• P.L. 2018, c.32 (Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act)
• NJ Dept of Banking and Insurance, Independent Health Care Appeals Program (IHCAP)
• NJ Division of Medical Assistance and Health Services (DMAHS), Medicaid fair hearing notice update
• NJ Division of Medical Assistance and Health Services (DMAHS), home
• New Jersey Attorney General
• 2026 federal poverty guidelines (U.S. Dept. of Health and Human Services, published on HealthCare.gov)
• Medicaid and CHIP by state (HealthCare.gov)
• 15 U.S.C. § 1673 federal wage-garnishment cap (GovInfo)