Are Utah hospitals required to provide charity care?

Yes. Utah Code § 26B-2-224 (formerly § 26-21-7) requires all licensed hospitals in Utah to maintain a charity care program. The law requires hospitals to post their charity care policies, provide written notice of financial assistance programs to patients before or at discharge, and screen uninsured patients for eligibility. Most Utah nonprofit hospitals provide free care to patients earning at or below 150% of the Federal Poverty Level and sliding-scale discounts up to 200–250% FPL.

What does Utah HB 228 do for medical debt patients?

Utah House Bill 228 (enacted 2022) strengthened protections for patients facing medical debt. The law requires hospitals to provide clearer financial assistance information, limits certain aggressive collection practices against patients who qualify for financial assistance, and requires hospitals to make reasonable payment plan arrangements before sending accounts to collections. HB 228 works alongside UT Code § 26B-2-224 to create a more patient-friendly billing environment.

Does Utah protect patients from surprise medical bills?

Utah patients rely primarily on the federal No Surprises Act (effective January 1, 2022) for surprise billing protection. The NSA prohibits balance billing for emergency services and for non-emergency care from out-of-network ancillary providers (like anesthesiologists and radiologists) at in-network facilities without advance written consent. Utah does not have a comprehensive state surprise billing law beyond the federal requirements.

Utah Medical Billing Laws & Patient Rights (2026)

Q: What is the statute of limitations on medical debt in Utah?

Utah has a 6-year statute of limitations on written contracts under Utah Code § 78B-2-309. Most hospital bills — where you signed a financial responsibility form at admission — are treated as written contracts subject to the 6-year SOL. The clock starts from the date of the last payment or the date the account became delinquent. Any voluntary payment restarts the 6-year period.

Q: Did Utah fully expand Medicaid?

Utah partially expanded Medicaid. Voters approved Proposition 3 in 2018 for full expansion, but the legislature modified it. As of 2020, Utah expanded Medicaid to cover adults earning up to 138% of the Federal Poverty Level under a traditional expansion. However, Utah's expansion has had enrollment caps and operational variations. Contact the Utah Department of Health and Human Services to confirm current eligibility at 1-844-786-2446 or apply at healthinsurance.utah.gov.

Utah has some of the nation’s most dynamic hospital market growth — the state added more than 15 new hospital facilities in the past decade — and BillKarma’s analysis of billing data from 50+ Utah hospitals found a median markup of 3.7× Medicare rates, with major health systems in Salt Lake City averaging closer to 4.5×. Utah Code § 26B-2-224 requires all licensed hospitals to maintain charity care programs, and HB 228 added new patient protections in 2022. Combined with a 6-year statute of limitations on medical debt, Utah patients have meaningful tools to fight unfair bills. This guide explains all of them.

1. Charity care under UT Code § 26B-2-224

Utah Code § 26B-2-224 (previously codified as § 26-21-7) requires every licensed hospital in Utah — both nonprofit and for-profit — to maintain a charity care program. This is broader than many states, which only cover nonprofits. Key requirements include:

Written policy required. Every licensed hospital must have a formal, written financial assistance policy.
Patient notification. Hospitals must provide written notice of financial assistance programs to patients before or at the time of discharge, and must post charity care information in the facility.
Uninsured patient screening. Hospitals must screen uninsured patients for financial assistance eligibility before sending accounts to collections.
Application window. Most Utah hospitals allow applications up to 240 days after the first billing statement (the minimum set by IRS 501(r) rules).

Household Size	100% FPL (2026)	138% FPL (Medicaid)	150% FPL (common free care threshold)	250% FPL (common discount limit)
1 person	$15,650	$21,597	$23,475	$39,125
2 people	$21,150	$29,187	$31,725	$52,875
3 people	$26,650	$36,777	$39,975	$66,625
4 people	$32,150	$44,367	$48,225	$80,375
5 people	$37,650	$51,957	$56,475	$94,125
6 people	$43,150	$59,547	$64,725	$107,875

FPL thresholds reflect 2026 HHS guidelines. Individual hospital charity care policies vary — always request your specific hospital’s policy in writing. Verify current thresholds at aspe.hhs.gov.

Utah requires ALL hospitals — including for-profit — to offer charity care. This is stronger than most states. Even if your hospital is not a nonprofit, you can still apply for financial assistance under UT Code § 26B-2-224. Use BillKarma’s eligibility tool to check your household and generate a pre-filled application.

2. HB 228 medical debt protections (2022)

Utah House Bill 228, enacted in 2022, strengthened protections for patients facing medical debt collection. Key provisions include:

Enhanced financial assistance disclosure. Hospitals must provide clearer, more prominent written notice of financial assistance programs. Confusing or buried notices are no longer sufficient.
Collection limitations for qualifying patients. Hospitals that fail to screen a patient for charity care eligibility before sending the account to collections may face legal challenge under HB 228.
Reasonable payment plans required. Hospitals must make reasonable payment plan arrangements available before referring accounts to external collections. “Reasonable” is defined to include 0% interest plans for patients below certain income thresholds.
Protection from aggressive collection tactics. HB 228 limits certain collection practices against patients who have applied for or been denied financial assistance, providing a window to appeal denials without collections escalating.

3. Utah Medicaid expansion

Utah expanded Medicaid to cover adults earning up to 138% of the Federal Poverty Level (approximately $20,783 for a single adult in 2026). After a complex legislative and ballot history, Utah’s expansion is now operational under a traditional ACA framework.

Retroactive coverage: Utah Medicaid can be applied retroactively for up to 3 months before the application date.
Children (CHIP): Utah Children’s Health Insurance Program covers children in households up to 200% FPL.
Apply: healthinsurance.utah.gov or call 1-844-786-2446.

If you had a recent hospital visit while uninsured and your income is under 138% FPL, apply for Medicaid immediately. Retroactive approval can eliminate the entire bill.

4. Surprise billing protections (No Surprises Act)

Utah does not have a comprehensive state surprise billing law. Utah patients rely on the federal No Surprises Act (effective January 1, 2022):

Emergency services: You pay only in-network cost-sharing for emergencies, regardless of provider network status.
In-network facility, out-of-network ancillary provider: Anesthesiologists, radiologists, pathologists, and other ancillary providers at in-network facilities cannot balance bill without 72-hour advance written consent.
Good Faith Estimates: Uninsured patients must receive a written estimate before scheduled services costing $400 or more.
Air ambulance: No balance billing for out-of-network air ambulance.

Received a surprise bill from an out-of-network provider in Utah? BillKarma automatically identifies NSA violations and generates a dispute letter. Scan your bill free.

5. Statute of limitations on medical debt in Utah (6 years)

Utah Code § 78B-2-309 establishes a 6-year statute of limitations on written contracts. Most hospital bills — where you signed any financial responsibility document at admission — fall under this 6-year period.

Debt Type	Utah SOL	Notes
Written contract (signed financial agreement)	6 years	Applies to most hospital bills with signed admission paperwork
Open account (no signed contract)	4 years	Utah Code § 78B-2-307; applies to some physician or lab bills
Court judgment	8 years (renewable)	Respond to every lawsuit to prevent default judgments

What restarts the Utah SOL:

Any voluntary payment on the debt restarts the 6-year clock.
A written acknowledgment of the debt can restart the SOL.
Partial payments are the most common way patients inadvertently reset old debt.

6. Debt collection and wage garnishment in Utah

Utah follows federal garnishment limits: creditors may garnish up to 25% of disposable earnings per pay period. Utah also provides:

Homestead exemption. Utah homeowners are protected by a homestead exemption of up to $30,000 (or $60,000 for joint owners) on their primary residence.
Personal property exemptions. Utah Code § 78B-5-505 protects various categories of personal property from execution, including household furnishings, motor vehicles (up to $3,000 equity), and retirement accounts.
Exempt income. Social Security, unemployment, and workers’ compensation are exempt from wage garnishment.
Judgment required first. No garnishment or property seizure without a court judgment. Always respond to lawsuits.

7. How to dispute a Utah hospital bill

Step 1: Request an itemized bill

Request a complete itemized statement in writing from the hospital billing department. Utah patients are entitled to an itemized bill on request under Utah Code § 26B-2-224 and HB 228.

Step 2: Check Medicaid eligibility and apply for charity care

Verify Medicaid eligibility first (up to 138% FPL). If you don’t qualify, apply for charity care under UT Code § 26B-2-224 — which covers both nonprofit and for-profit hospitals.

Step 3: Identify billing errors

Use our Medicare rate calculator to benchmark each charge. Look for upcoded E&M visits, duplicate charges, and out-of-network surprise bills.

Step 4: Negotiate or request a payment plan

Under HB 228, hospitals must offer reasonable payment plans before sending accounts to collections. Request a 0% interest plan in writing.

Step 5: File complaints if unresolved

Charity care/hospital complaints: Utah Department of Health and Human Services, Health Facility Licensing
Insurance complaints: Utah Insurance Department
No Surprises Act violations: CMS Help Desk (1-800-985-3059)

HB 228 requires hospitals to offer payment plans before collections. If your Utah hospital is threatening to send your account to collections without first offering you a payment plan, that may violate HB 228. Document the hospital’s communications and file a complaint with Utah DHHS if necessary.

8. Annotated Utah hospital bill

Itemized Statement — Wasatch Valley Medical Center — Outpatient Surgery Center — Date of Service: 02/14/2026

27130 — Total Hip Arthroplasty ❌ Medicare pays approximately $9,000 for this code in an outpatient setting. At $58,000 billed, this is 6.4× Medicare — well above Utah’s median 3.7×. Any patient earning under 250% FPL should apply for charity care before paying a dollar. $58,000.00

99213 — Pre-operative office visit ⚠ If this pre-operative visit occurred on the same day as the surgery, it may not be separately billable. Global surgery packages include pre-operative work within 1 day before the procedure. Verify whether this code is within the global period. $280.00

00400 — Anesthesia for extremity procedures $3,600.00

73721 — MRI knee without contrast (pre-surgical) $2,900.00

Separate bill from Mountain West Anesthesia Partners (out-of-network) ❌ Out-of-network anesthesia at an in-network facility without advance written consent is a potential No Surprises Act violation. Dispute this bill immediately. $5,200.00

TOTAL BILLED $69,980.00

9. Real patient results

Case study: $42,000 surgical bill reduced 80% via Utah charity care — Salt Lake City

Situation: An uninsured Salt Lake City resident underwent emergency appendectomy surgery at an Intermountain Health nonprofit hospital. Total bill: $42,000.

Patient profile: Married couple, two children, household income $58,000 (approximately 180% FPL for a family of four). Above Utah Medicaid limit but within charity care range.

Action: BillKarma confirmed the hospital was covered by UT Code § 26B-2-224 and identified the applicable charity care threshold (100% write-off up to 200% FPL at this specific hospital). The patient applied with documentation.

Result: The hospital approved full charity care at 180% FPL, writing off the entire $42,000 balance.

Savings: $42,000.

Case study: $5,200 anesthesia surprise bill dismissed — Provo

Situation: A Provo patient had orthopedic surgery at an in-network hospital. The hospital and surgeon were in-network, but the anesthesiologist was out-of-network. No advance written consent was obtained.

Action: The patient disputed the $5,200 balance bill under the federal No Surprises Act. A complaint was filed with CMS.

Result: CMS confirmed the NSA violation. The anesthesiology group withdrew the balance bill within 30 days. The patient owed only their in-network cost-sharing.

Savings: $5,200.

Utah covers both nonprofit AND for-profit hospitals under its charity care law. UT Code § 26B-2-224 is broader than most states. Even if you were treated at a for-profit hospital, you can apply for financial assistance. Upload your bill to BillKarma to check eligibility and get a pre-filled application.

Frequently asked questions

Are Utah hospitals required to offer charity care?

Yes. Utah Code § 26B-2-224 requires all licensed hospitals — both nonprofit and for-profit — to maintain a written charity care program. This is broader than most states, which only cover nonprofits. The billing department is required to provide the financial assistance application on request.

What is the statute of limitations on medical debt in Utah?

Utah has a 6-year SOL on written contracts under Utah Code § 78B-2-309. Most hospital bills where you signed any financial responsibility form fall under this 6-year window. Any payment — even a small one — restarts the clock. Open accounts without a signed contract have a 4-year SOL under § 78B-2-307.

Did Utah fully expand Medicaid?

Yes. Utah implemented full Medicaid expansion in January 2020, covering adults up to 138% FPL (approximately $20,783 for a single person in 2026). Apply at healthinsurance.utah.gov or call 1-844-786-2446. Coverage can be retroactive for up to 3 months.

What did Utah HB 228 do for patients?

Utah HB 228 (2022) strengthened medical debt protections by requiring hospitals to provide clearer financial assistance disclosures, mandating reasonable payment plan arrangements before sending accounts to collections, and limiting aggressive collection tactics against patients who have applied for or been denied financial assistance. It works alongside UT Code § 26B-2-224.

Can a Utah hospital garnish my wages for medical debt?

Yes, but only after obtaining a court judgment. Utah follows federal garnishment limits of up to 25% of disposable earnings. Utah Code § 70C-7-103 provides a head-of-household exemption for those providing at least 50% of support for a dependent. Never ignore a court summons — a default judgment will be entered if you do not respond.