On July 7, the CFPB, Centers for Medicare & Medicaid Services (CMS), Department of Health & Human Services (HHS), and Department of the Treasury issued a formal request for information regarding forms of consumer-facing healthcare financing. The inquiry specifically solicits comments “from the public and interested parties on medical credit cards, loans, and other financial products used to pay for health care.” The RFI follows the CFPB’s May 2023 Report on point-of-sale healthcare financing products, where the CFPB concluded that these “costly” forms of financing were being “pushed” on consumers and that they could deter consumers “from seeking needed healthcare in the future.” Comments responding to the RFI are due September 11, 2023.
While the CFPB’s follow-up inquiry to the May Report may not be surprising, it seems to have been strategic in partnering with CMS, HHS, and the Treasury Department. As the CFPB subtly acknowledged in its May Report, healthcare providers generally do not fall under the scope of the CFPB’s supervisory and enforcement jurisdiction; accordingly, a request for information from the CFPB alone may not have had much impact. Expanding the inquiry to CMS and HHS – which do have sway over providers’ operations – ensures that providers will have the incentive to provide responses.
As is clear from the tenor of the CFPB’s May Report (and, to a lesser extent, the RFI itself), the CFPB appears skeptical that point-of-sale financing provides any benefit to healthcare consumers. One troubling theme in the CFPB’s comments is that it seems to believe that interest-free payment plans are and should continue to be an option for consumers for medical debts not covered by insurance and that can’t be paid upfront. Given current market conditions, providers might balk at the assumption that typically they should be willing to eat the cost of deferring payment for services rendered.
Providers that use or are considering point-of-sale financing products should be prepared to provide a strategic response to the RFI that addresses some of the CFPB’s concerns. More fundamentally, providers should be prepared for the event that the CFPB, HHS, and CMS proceed with formal rulemaking regarding point-of-sale financing options. The RFI could be the first step toward joint regulations issued by federal agencies that rarely have overlapping interests. In this case, the same activity that the CFPB and Treasury may see as having consumer protection implications also has federal health program beneficiary protection ramifications. Point-of-service financing would simply be a new twist on HHS and CMS’s long-held concerns about medical providers (particularly licensed medical professionals) deriving profits from services ancillary to the direct patient care they provide.