Washington State law requires medical debt providers to wait at least 120 days after sending an initial billing statement before selling or assigning the debt to a licensed collection agency. This 120-day waiting period, established by Substitute House Bill 1531 in 2019 and codified in RCW 70.54.470, gives patients four months to pay, negotiate, or explore other options before a debt changes hands.
Additionally, as of July 2025, Washington prohibited collection agencies from reporting medical debt to credit bureaus altogether—a protection that goes beyond the delay alone. This means Washington offers some of the strongest protections in the nation for patients facing medical bills. The 120-day rule is straightforward, but its limits matter: it does not prevent the original provider from collecting directly during those four months, and it applies only to licensed collection agencies, not to in-house collection efforts.
Table of Contents
- The 120-Day Wait: What It Covers
- What the Law Does Not Prevent
- Medical Debt and Credit Reports
- How Long Can a Collector Pursue You?
- Financial Assistance Before Collections
- What to Do If Contacted by a Collection Agency
The 120-Day Wait: What It Covers
The 120-day clock starts when a health care provider or facility sends you an initial billing statement. This means the four-month period begins from the date the bill reaches you, not from the date you receive a collection notice or from when the debt is sold.
Once the clock starts, the provider cannot legally sell or assign the debt to a licensed collection agency until 120 days have passed. The rule applies broadly to hospitals, clinics, physician offices, and any entity whose primary business is providing medical services, products, or devices. It covers both the initial debt sale and any reassignment afterward—if a debt changes hands, the original 120-day protection still applies.
What the Law Does Not Prevent
Many patients assume the 120-day rule means they have four months before any collection effort. The rule, however, prevents *sale to a licensed collection agency*, but it does not prevent the original provider from attempting to collect directly throughout those 120 days. hospitals and clinics can call, mail bills, and pursue collection methods themselves without violating this law—they simply cannot hand the debt off to an outside agency.
Medical Debt and Credit Reports
Starting July 27, 2025, Washington collection agencies are prohibited from reporting medical debt to credit reporting agencies entirely. This means that even *after* the 120-day period expires and a debt is transferred to a collector, the collector cannot damage your credit score by filing a report with Equifax, Experian, or TransUnion. Previously, the law created a softer delay: under the earlier rules, collectors had to wait an additional 180 days after receiving a debt before reporting it to credit bureaus.
That rule is now superseded—the prohibition is absolute. Your credit report is protected from medical debt harm regardless of collection status.
How Long Can a Collector Pursue You?
Although medical debt cannot appear on credit reports, collectors can still attempt to collect for years—but not indefinitely. Washington imposes a six-year statute of limitations on medical debt: collection attempts cannot proceed after six years from when the debt first originated. If a debt is older than six years, the statute of limitations has expired and collectors cannot legally continue collection efforts. If you believe a collector has contacted you about a time-expired debt, keep records of all communications.
Financial Assistance Before Collections
Large hospitals in Washington have their own obligation. Facilities with over $25 million in annual revenue must screen patients for financial assistance eligibility and provide free care to those below 300 percent of the federal poverty line before pursuing collections. If you have not been offered this assistance when your bill arrived, ask to speak with a financial counselor or patient advocate.
Many hospitals reduce or forgive entire bills for uninsured or underinsured patients. Do not assume you owe the full amount; a conversation with the hospital's financial assistance team may eliminate the debt before the 120-day period even begins.
What to Do If Contacted by a Collection Agency
If a collection agency contacts you about medical debt, you have rights under federal law. Under the Fair Debt Collection Practices Act, collectors cannot call before 8 a.m., after 9 p.m., at work if your employer forbids it, or repeatedly to harass you. You can request in writing that they stop contacting you, and they must comply.
You also have the right to request that the collector verify the debt. Send this request within 30 days of first contact by certified mail (keep a copy) and ask them to verify the amount owed, the date of service, and the original creditor's name. Many collectors cannot produce valid documentation, which often leads them to abandon the collection effort.