Long Beach, California Advances Medical Debt Reporting Ordinance With Fines Up to $10,000
The Long Beach City Council has advanced a proposed medical debt reporting ordinance that would require four local hospitals to disclose debt collection activities and patient financial assistance information, with potential fines reaching $10,000 per violation.
During its Nov. 10 meeting, the council approved the ordinance’s first reading and moved it forward for final consideration at a subsequent meeting. Councilmembers also approved an agreement authorizing Los Angeles County to administer and enforce the reporting program.
The proposal would extend existing county medical debt oversight requirements into Long Beach, adding another California municipality to a growing regional effort to monitor hospital billing and collection practices.
Four Hospitals Would Face New Reporting Requirements
The proposed ordinance would apply to four general acute care hospitals:
- MemorialCare Long Beach Medical Center
- MemorialCare Miller Children’s & Women’s Hospital
- Dignity Health St. Mary Medical Center
- College Medical Center
Under the proposed ordinance, hospitals would report information about accounts entering collections, including outstanding balances, payments, billing adjustments, and financial assistance provided to patients.
Most hospitals would have 30 days after initiating collection activities to submit required account information. Designated safety-net hospitals would receive 60 days.
Hospitals would also submit periodic summaries of their collection and financial assistance activities. Reporting would generally occur quarterly, with qualifying safety-net hospitals reporting annually.
Hospitals that fail to comply could face initial penalties of up to $5,000 per violation. Unresolved violations could result in penalties increasing to $10,000 after 30 days, with additional enforcement measures possible for continued noncompliance.
Long Beach Follows Los Angeles County’s Medical Debt Initiative
The proposal builds on a medical debt reporting ordinance adopted by Los Angeles County in September 2024, which requires hospitals under its jurisdiction to provide standardized information about debt collection and financial assistance practices.
The city of Los Angeles adopted corresponding requirements in February 2026, extending the reporting program to 34 additional acute care hospitals. That ordinance took effect March 30.
According to the Los Angeles County Department of Public Health, the reporting program is intended to identify gaps in financial assistance practices, including cases in which patients potentially eligible for free or discounted care are referred to collections.
A 2026 county report estimated that medical debt affected approximately one in 10 Los Angeles County adults in 2024, with outstanding medical debt exceeding $2.8 billion.
What the Proposal Means for Medical Debt Collection
The ordinance would not prohibit medical debt collection or automatically cancel outstanding patient balances. Instead, it would increase reporting and oversight of how hospitals manage unpaid accounts and administer financial assistance programs.
For third-party collection agencies working with affected hospitals, the requirements could create additional data-sharing and documentation responsibilities. Hospitals may need detailed information from their collection partners to accurately report account balances, collection activity, payments, and adjustments.
The proposal also reflects increasing local oversight of medical debt practices, particularly the relationship between hospital financial assistance eligibility and accounts placed into collections.
Long Beach’s ordinance still requires final consideration before becoming law. If adopted and approved by the mayor, it would take effect 31 days after mayoral approval.
