EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb1364*
HOUSE BILL 1364
J3, J2, J5 2lr2537
By: Delegates Cox, Arikan, Boteler, Mautz, McComas, and Rose
Introduced and read first time: February 11, 2022
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Health Care Freedom of Conscience Act 2
FOR the purpose of authorizing health care providers and health care practitioners to 3
decline to participate in a health care service that violates their conscience; 4
authorizing health care payors to decline to pay for health care services or health 5
care products that violate their conscience; establishing certain civil, criminal, and 6
administrative immunity; prohibiting a unit of State or local government or a person 7
from discriminating against health care providers, health care practitioners, or 8
health care payors and certain other persons because the person declines or will 9
decline to take certain actions that violate their conscience; and generally relating to 10
the freedom of conscience for health care providers, health care practitioners, and 11
health care payors. 12
BY renumbering 13
Article – Insurance 14
Section 15–801 15
to be Section 15–801.1 16
Annotated Code of Maryland 17
(2017 Replacement Volume and 2021 Supplement) 18
BY adding to 19
Article – Health – General 20
Section 24–1801 through 24–1805 to be under the new subtitle “Subtitle 18. Health 21
Care Freedom of Conscience Act” 22
Annotated Code of Maryland 23
(2019 Replacement Volume and 2021 Supplement) 24
BY adding to 25
Article – Insurance 26
Section 15–801 27
Annotated Code of Maryland 28 2 HOUSE BILL 1364
(2017 Replacement Volume and 2021 Supplement) 1
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 2
That Section(s) 15–801 of Article – Insurance of the Annotated Code of Maryland be 3
renumbered to be Section(s) 15–801.1. 4
SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland read 5
as follows: 6
Article – Health – General 7
SUBTITLE 18. HEALTH CARE FREEDOM OF CONSCIENCE ACT. 8
24–1801. 9
(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANING S 10
INDICATED. 11
(B) “CONSCIENCE” MEANS RELIGIOUS , MORAL, OR ETHICAL PRINCIPLE S 12
HELD BY A PERSON AND PROVIDED FOR IN A PERSON’S: 13
(1) RELIGIOUS, MORAL, OR ETHICAL GUIDELINE S; OR 14
(2) MISSION STATEMENT , CONSTITUTION , BYLAWS, ARTICLES OF 15
INCORPORATION , REGULATIONS , OR OTHER RELEVANT DO CUMENTS. 16
(C) “DISCRIMINATE” INCLUDES TERMINAT E, TRANSFER, REFUSING STAFF 17
PRIVILEGES, REFUSING BOARD CERTIFICATION , CARRYING OUT ADVERSE 18
ADMINISTRATIVE ACTIO N, DEMOTION, CAUSING THE LOSS OF A CAREER SPECIALTY , 19
REASSIGNMENT TO A DIFFERENT SHIFT , REDUCING WAGES, REDUCING BENEFITS, 20
REFUSAL TO AWARD A GRANT OR CONTRACT, REFUSAL TO PROVIDE TRAI NING 21
OPPORTUNITIES , ISSUING A PENALTY, OR CONDUCT ING ANY OTHER DISCIPLINA RY 22
ACTION. 23
(D) “HEALTH CARE PRACTITIONER ” MEANS AN INDIVIDUAL WHO 24
REGULARLY PARTICIPAT ES IN A HEALTH CARE SERVICE AND WHO IS NOT A HEA LTH 25
CARE PROVIDER , INCLUDING A PHARMACY EMPLOYEE , A RESEARCHER , A MEDICAL 26
OR NURSING SCHOOL FA CULTY MEMBER, A STUDENT, OR AN EMPLOYEE OR ANY 27
PROFESSIONAL OR PARAPROFESSIONAL WHO FURNISHES OR ASSISTS IN THE 28
FURNISHING OF HEALTH CARE SERVICES. 29
(E) “HEALTH CARE PROVIDER” HAS THE MEANING STATED IN § 19–132 OF 30
THIS ARTICLE. 31
HOUSE BILL 1364 3
(F) (1) “HEALTH CARE SERVICE” HAS THE MEANING STATED IN § 1
19–132 OF THIS ARTICLE. 2
(2) “HEALTH CARE SERVICE ” INCLUDES RESEARCH, INSTRUCTION, 3
OR ANY OTHER CARE OR TREATMENT RENDERED B Y HEALTH CARE PROVIDERS. 4
(G) “PARTICIPATE IN A HEALTH CARE SERVICE” MEANS TO COUNSEL , 5
ADVISE, PROVIDE, PERFORM, ASSIST IN, REFER FOR, ADMIT FOR PURPOSES O F 6
PROVIDING, OR PARTICIPATE IN PR OVIDING A HEALTH CARE SERVICE OR ANY FORM 7
OF A HEALTH CARE SERVICE. 8
(H) “PAYOR” HAS THE MEANING STAT ED IN § 19–132 OF THIS ARTICLE. 9
24–1802. 10
(A) THE GENERAL ASSEMBLY FINDS THAT : 11
(1) IT IS THE PUBLIC POLI CY OF THE STATE TO RESPECT AND 12
PROTECT THE FUNDAMEN TAL RIGHT OF CONSCIE NCE OF HEALTH CARE PROVIDERS 13
AND HEALTH CARE PRAC TITIONERS; AND 14
(2) WITHOUT COMPREHENSIVE PROTECTION, HEALTH CARE RIGHTS 15
OF CONSCIENCE MAY BE VIOLATED IN VARIOUS WAYS, INCLUDING HARASSMENT , 16
DEMOTION, SALARY REDUCTION , TRANSFER, TERMINATION , LOSS OF STAFFING 17
PRIVILEGES, DENIAL OF AID OR BEN EFITS, AND REFUSAL TO LICEN SE OR REFUSAL 18
TO CERTIFY. 19
(B) BASED ON THE FINDINGS IN SUBSECTION (A) OF THIS SECTION, IT IS THE 20
PURPOSE OF THIS SUBTITLE TO: 21
(1) PROTECT AS A BASIC CI VIL RIGHT, THE RIGHT OF ALL HEALTH 22
CARE PROVIDERS, HEALTH CARE PRACTITIONERS , AND PAYORS TO DECLINE TO 23
COUNSEL, ADVISE, PAY FOR, PROVIDE, PERFORM, ASSIST, OR PARTICIPATE IN 24
PROVIDING OR PERFORM ING HEALTH CARE SERVICES THAT VIOLATE THEIR 25
CONSCIENCES , INCLUDING: 26
(I) ABORTION; 27
(II) ARTIFICIAL BIRTH CONT ROL; 28
(III) STERILIZATION; 29
(IV) ARTIFICIAL INSEMINATI ON; 30 4 HOUSE BILL 1364
(V) ASSISTED REPRODUCTION ; 1
(VI) HUMAN EMBRYONIC STEM CELL RESEARCH AND FETAL 2
EXPERIMENTATION ; 3
(VII) HUMAN CLONING ; AND 4
(VIII) PHYSICIAN–ASSISTED SUICIDE AND EUTHANASIA; AND 5
(2) PROHIBIT ALL FORMS OF DISCRIMINATION , DISQUALIFICATION , 6
COERCION, DISABILITY, OR LIABILITY ON HEALTH CARE PROVIDERS, HEALTH CARE 7
PRACTITIONERS , AND PAYORS THAT DECLINE TO PERFORM O R PROVIDE A HEALTH 8
CARE SERVICE THAT VI OLATES THEIR CONSCIE NCES. 9
24–1803. 10
(A) (1) A HEALTH CARE PROVIDER OR HEALTH CARE PRACT ITIONER MAY 11
DECLINE TO PARTICIPATE IN A HEALTH CARE SERVICE THAT VI OLATES THE 12
CONSCIENCE OF THE HEALTH CARE P ROVIDER OR HEALTH CA RE PRACTITIONER . 13
(2) A HEALTH CARE PAY OR MAY DECLINE TO PAY OR ARRANGE 14
PAYMENT FOR A HEALTH CARE SERVICE OR HEAL TH CARE PRODUCT THAT VIOLATES 15
THE CONSCIENCE OF TH E PAYOR. 16
(B) (1) A HEALTH CARE PROVIDER OR A HEALTH CARE PRACTITIONER IS 17
NOT CIVILLY, CRIMINALLY, OR ADMINISTRATIVELY LIABLE FOR DECLINING TO 18
PARTICIPATE IN A HEALTH CARE SERVICE THAT VIOLATE S THE CONSCIENCE OF THE 19
HEALTH CARE PROVIDER OR HEALTH C ARE PRACTITIONER . 20
(2) A HEALTH CARE PROVIDER THAT IS A HEALTH CAR E FACILITY IS 21
NOT CIVILLY, CRIMINALLY, OR ADMINISTRATIVELY LIABLE FOR DECLINING TO 22
PARTICIPATE IN A HEA LTH CARE SERVICE IF THE HEALTH CARE FACILITY PROVIDES 23
A CONSENT FORM TO BE SIGNED BY A PATIENT BEFORE ADMISSION TO THE FACILITY 24
STATING THAT THE HEALTH CARE FACILITY RESERVES THE RIGHT T O DECLINE TO 25
PARTICIPATE IN A HEALTH CARE SERVICE THAT VIOLATE S ITS CONSCIENCE . 26
(3) A PAYOR OR PERSON THAT OWNS , OPERATES, SUPERVISES, OR 27
MANAGES A PAYOR IS N OT CIVILLY OR CRIMIN ALLY LIABLE FOR DECL INING TO PAY 28
FOR OR ARRANGE PAYME NT FOR A HEALTH CARE SERVICE OR HEALTH CA RE 29
PRODUCT THAT VIOLATE S THE CONSCIENCE OF THE HEALTH CARE PAYOR. 30
(C) A UNIT OF STATE OR LOCAL GOVERNMENT OR PERSON MAY NOT 31 HOUSE BILL 1364 5
DISCRIMINATE AGAINST : 1
(1) A HEALTH CARE PROVIDER OR HEALTH CARE PRACTITIONER 2
BASED ON THE HEALTH CARE PROVIDER OR HEA LTH CARE PRACTITIONER 3
DECLINING TO PARTICI PATE IN A HEALTH CAR E SERVICE THAT VIOLA TES THE 4
CONSCIENCE OF THE HE ALTH CARE PROVIDER O R HEALTH CARE PRACTITIONER ; 5
(2) A HEALTH CARE PROVIDER OR A PERSON ATTEMPTI NG TO 6
ESTABLISH A HEALTH C ARE PROVIDER BECAUSE THE PROPOSED OR EXISTING 7
HEALTH CARE PROVIDER DECLINES OR WILL DEC LINE TO PARTICIPATE IN A HEALTH 8
CARE SERVICE THAT VIOLATES THE CONSCIE NCE OF THE HEALTH CA RE PROVIDER; 9
OR 10
(3) A PAYOR OR A PERSON ATTEMPTING TO ESTABLISH A PAYOR 11
BECAUSE THE PROPOSED OR EXISTING PAYOR DE CLINES OR WILL DECLINE TO PAY 12
FOR OR ARRANGE PAYME NT FOR A HEALTH CARE SERVICE OR PRODUCT THAT 13
VIOLATES THE CONSCIE NCE OF THE PAYOR . 14
24–1804. 15
(A) (1) A CIVIL ACTION FOR DAM AGES OR INJUNCTIVE R ELIEF, OR BOTH, 16
MAY BE BROUGHT AGAINST A PERSON OR A UNIT OF STATE OR LOCAL GOVERNMENT 17
FOR A VIOLATION OF THIS SU BTITLE. 18
(2) IT IS NOT A DEFENSE TO A CLAIM ARISING OUT OF THE VIOLATION 19
THAT A VIOLATION WAS NECES SARY TO PREVENT ADDI TIONAL BURDEN OR EXP ENSE 20
ON A HEALTH CARE PROVIDER . 21
(B) (1) ON A FINDING OF A VIOLATION OF THIS SUBTITLE BY A COURT OF 22
COMPETENT JURISDICTI ON, THE AGGRIEVED PARTY IS ENTITLED TO RECOVER : 23
(I) TREBLE DAMAGES, INCLUDING PAIN AND S UFFERING 24
SUSTAINED BY THE INDIVIDUAL, ASSOCIATION, CORPORATION , ENTITY, OR HEALTH 25
CARE PROVIDER; 26
(II) COURT COSTS; AND 27
(III) REASONABLE COUNSEL FEES. 28
(2) A RECOVERY BY AN AGGRIEVED PART Y IN AN ACTION BROUG HT 29
UNDER THIS SECTION SHALL BE NOT LESS THAN $5,000 FOR EACH VIOLATION I N 30
ADDITION TO COURT COSTS AND REASONABLE ATTOR NEY’S FEES. 31
6 HOUSE BILL 1364
(3) THE DAMAGE REMEDIES PROVIDED IN THIS SUB SECTION SHALL 1
BE CUMULATIVE AND NO T EXCLUSIVE OF OTHER REMEDIES AFFORDED UN DER 2
STATE OR FEDER AL LAW. 3
24–1805. 4
THIS SUBTITLE MAY BE CITED A S THE MARYLAND HEALTH CARE FREEDOM 5
OF CONSCIENCE ACT. 6
Article – Insurance 7
15–801. 8
THE REQUIREMENTS IN THIS SUBTITLE ARE SUBJECT TO THE MARYLAND 9
HEALTH CARE FREEDOM OF CONSCIENCE ACT. 10
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 11
October 1, 2022. 12