On July 7, 2023, the Consumer Financial Protection Bureau (CFPB), U.S. Department of Health and Human Services (HHS), and U.S. Department of the Treasury (Treasury) issued a Request for Information on Medical Payment Products (RFI), such as medical credit cards and installment loans.

The agencies seek to understand these products’ effects on patients and the health care system. In particular, the agencies seek comment “on whether these products may allow health care providers to operate outside of a broad range of patient and consumer protections.” The agencies also seek comment on whether these products may contribute to health care cost inflation, displace hospitals’ provision of financial assistance, lead patients to pay inaccurate or inflated medical bills, and create disparities across different demographic groups, among other topics.

The RFI builds on a prior CFPB Report, which provided an overview of medical credit cards and loans used for services and procedures for medical treatment and emergency health care.

Further signaling a potential increase in regulatory scrutiny, Deputy Secretary of the Treasury Wally Adeyemo said, “Treasury is proud to partner with agencies across the Biden administration to crack down on these often abusive practices that take advantage of patients during vulnerable times. We look forward to receiving stakeholder input so that we can better protect patients and consumers.” CFPB Director Rohit Chopra added, “Financial firms are partnering with health care players to push products that can drive patients deep into debt,” noting that the CFPB plans to use the information and public input in its consideration of ways to address patient harms these financial products cause. The agencies further commented and are expected to focus heavily on origination, debt collection, and credit reporting practices of financial companies that originate and service products. Specifically, the agencies are requesting information about the following:

• The specialty medical payment product market. The agencies are interested in data and comments on the interest and fee costs for these products and in understanding their marketing, application, and approval processes. The CFPB is also interested in trends in medical payment product use, including the total outstanding consumer debt on medical credit cards, medical installment loans, and other medical payment products.
• Patient experiences and downstream consequences. The agencies want to know more about these products’ risks and whether consumers fully understand such risks.
• Billing and financial assistance issues. The agencies want to learn more about how medical credit cards and loans may exacerbate existing issues in health care billing and collections, e.g., whether uninsured and out-of-network patients are charged higher prices than those negotiated by in-network insurers for the same medical services.
• Health care provider incentives. The agencies want to learn more about incentives offered to health care providers to promote medical payment products and how those incentives affect providers’ promotion of these products to patients. They are mainly seeking information about revenue sharing and processing or management fees.

Comments must be received within 60 days of publication of the request for information in the Federal Register. In addition, the CFPB hosted a hearing on July 11, 2023, to address medical billing and collection concerns with a focus on medical payment products. See Director Chopra’s remarks.