The Washington State Attorney General’s Office and state legislators have officially advanced strong protections to dismantle predatory practices in medical billing. As a former hospital billing auditor, I can tell you: hospitals rely on your ignorance of these laws to keep their revenue cycle moving. They want you to put that balance on a credit card or sign a payment plan.

Do not do it. Washington State has some of the strongest consumer protections in the country, but they are useless if you don’t know the specific codes and forms to use.

The Reality Check: Why This Matters

I saw exactly why this legislation is critical just last week in Snohomish County. A neighbor of mine—let’s call him Mark—opened his mailbox to find a “Final Notice” from a major hospital system in Everett. The bill was $4,500 for a 3-hour ER visit to treat a kidney stone.

Mark was hyperventilating. He was reaching for his high-interest credit card, ready to eat the debt just to make the scary letters stop. He didn’t know that because he makes $55,000 a year, he legally qualified for a major discount.

I stopped him. I looked at his bill, saw they had charged him a Level 5 ER visit (CPT Code 99285) for a Level 3 problem, and—more importantly—he was well within Washington’s mandatory Charity Care limits for discounted care. We filed the paperwork, and 48 hours later, his balance was reduced by 75%. This isn’t luck; it’s the law.

Eligibility: Do You Qualify for $0 Bills?

Washington State law, updated significantly in 2022, divides hospitals into two tiers based on their size. Most major hospitals (UW Medicine, Providence, MultiCare, Virginia Mason) are Tier 1. Under the current law, the income limits for total forgiveness are aggressive.

If your household income falls within these brackets, you are legally entitled to a discount. Do not take “No” for an answer.

*Based on official 2025 Federal Poverty Level (FPL) figures used by WA Charity Care law (HB 1616). Tiers vary for smaller (Tier 2) hospitals.

The Auditor’s Playbook: How to Wipe the Debt

If you just call customer service, they will offer you a payment plan. Do not accept it. Accepting a payment plan often legally validates the debt amount. Follow this specific sequence to slash the bill.

Step 1: The “Pause” Letter

Send a certified letter or a message via the patient portal (MyChart) stating: “I am applying for Washington State Charity Care under RCW 70.170. Please pause all collection activity and interest accrual as mandated by law.”

Step 2: Obtain the Application

Every hospital in WA is required to have this form online, but they hide it deep in the footer. Search “[Hospital Name] Financial Assistance Policy”.

👉 Find Your Hospital’s Form Here

Step 3: The Interest Rate Cap

If you do not qualify for 100% charity care, you still benefit from state law. If a hospital or debt collector attempts to add interest over 9% to your balance, cite the Washington Consumer Protection Act. Proposed legislation aims to lower this to 0%, but it is not yet law.

📚 Official Resources & Forms

• WA Attorney General Charity Care Page – The official law regarding your right to free care.
• WA State Hospital Association – Detailed breakdown of Tier 1 vs. Tier 2 hospitals.
• Dollar For (Non-Profit) – A free tool that helps you fill out the paperwork automatically.
• Office of the Insurance Commissioner – File a complaint here if a hospital violates the billing laws.

🙋‍♂️ Frequently Asked Questions (FAQ)

Does this apply to bills I already received in 2025?

Yes. Washington’s Charity Care law is retroactive. You can apply for forgiveness on bills that are months, and sometimes years old, provided they haven’t been fully settled in court. The expanded protections have been in effect since 2022.

What if I have health insurance?

You can (and should) still apply. Charity Care applies to your out-of-pocket costs—your deductibles and co-pays. If you owe $2,000 after insurance paid their share, Charity Care can wipe that $2,000 to zero.

Can they send me to collections while I apply?

No. Under state law, once you submit a Charity Care application, all collection activities must be suspended until the hospital makes a determination on your eligibility. If they call you during this time, tell them: “Account is pending Charity Care review.”

How long does the process take?

Hospitals typically have 14 business days to make a determination once they receive your full application. If they ignore you, file a complaint with the Attorney General immediately.

So don’t be like my panic-stricken neighbor Mark—apply today, use the law, and keep your money in your pocket.