Virginia

Process / partial

Hospitals must post and share their charity-care policies. There is no statewide FPL write-off floor. Medicaid expanded in 2019. Virginia restricts furnishers from reporting medical debt. Medical-debt interest is capped at 3% (Va. Code § 59.1-612), which also limits home foreclosure and wage garnishment for medical debt.

I.R.C. § 501(r); Va. Code § 32.1-137.01 (charity-care policy posting) · compiled October 2026

Rule	This state
Free-care floor	—
Discount / eligibility floor	—
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	Statewide ban (FCRA-preemption fights ongoing)
Debt sales	Not banned
Home liens	Restricted or banned
Wage garnishment	Tighter than the federal 25% cap
Interest on medical debt	Capped near 3%
Collection hold	No extra state waiting period
Lawsuit clock	5 years · Va. Code § 8.01-246 (written contracts, 5 years)

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	—	—
2	$21,640	—	—
3	$27,320	—	—
4	$33,000	—	—
5	$38,680	—	—
6	$44,360	—	—

What to do

01 Virginia has no write-off statute. Ask for the posted charity-care policy and apply to the FAP and Medicaid.
02 Medical debt generally should not be furnished from a Virginia provider to a bureau.
03 Medical-debt interest is capped at 3%. Read anything that would put your home up as security before signing.
04 Five-year written-contract window.

Appeals

Federal No Surprises Act.

Insurance: Virginia Bureau of Insurance — external review

Medicaid: DMAS fair hearing.

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

Cite this in a letter

Please send me your charity-care policy as Va. Code § 32.1-137.01 requires, and make a FAP determination under Internal Revenue Code section 501(r).

Put a Virginia bill in the machine.

The estimate will use this state’s floors. The letters will cite I.R.C. § 501(r); Va. Code § 32.1-137.01 (charity-care policy posting).

Start a Virginia case

Virginia 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.
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 Virginia information on this page. UNDUE does not represent any government entity.