Maryland 2023 Regular Session

Maryland House Bill HB333 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	WES MOORE, Governor Ch. 310
2	1
3		-	– 1 –
4		-	Chapter 310
5		-	(House Bill 333)
6	2
7		-	AN ACT concerning
	3	+	EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
	4	+	[Brackets] indicate matter deleted from existing law.
	5	+	Underlining indicates amendments to bill.
	6	+	Strike out indicates matter stricken from the bill by amendment or deleted from the law by
	7	+	amendment.
	8	+	hb0333
8	9
9		-	Hospitals – Financial Assistance – Medical Bill Reimbursement Process
	10	+	HOUSE BILL 333
	11	+	J3, Q7 3lr0720
	12	+	CF SB 404
	13	+	By: Delegate Charkoudian Delegates Charkoudian, Pena –Melnyk, Cullison,
	14	+	Alston, Bagnall, Bhandari, Guzzone, Hill, S. Johnson, Kaiser, Kerr,
	15	+	R. Lewis, Lopez, Martinez, Rosenberg, Taveras, White, and Woods
	16	+	Introduced and read first time: January 25, 2023
	17	+	Assigned to: Health and Government Operations
	18	+	Committee Report: Favorable with amendments
	19	+	House action: Adopted
	20	+	Read second time: March 5, 2023
10	21
11		-	FOR the purpose of establishing requirements related to the reimbursement of
12		-	out–of–pocket costs paid by certain hospital patients who were eligible for free care,
13		-	including requirements related to the consideration of data and the reporting and
14		-	disclosure of certain information; modifying the process the Health Services Cost
15		-	Review Commission is required to develop for identifying and reimbursing certain
16		-	patients of hospitals; providing that a hospital is not required to provide certain
17		-	reimbursements under certain circumstances; requiring the implementation of a
18		-	certain option from a certain report under certain circumstances; requiring a
19		-	hospital to reimburse certain State government entities for certain costs; making a
20		-	violation of this Act an unfair, abusive, or deceptive trade practice that is subject to
21		-	enforcement and penalties under the Maryland Consumer Protection Act;
22		-	authorizing the State Department of Assessments and Taxation and the Office of the
23		-	Comptroller to disclose tax information to hospitals and certain units for a certain
24		-	purpose; and generally relating to hospitals, financial assistance policies, and
25		-	reimbursement for paid bills.
	22	+	CHAPTER ______
26	23
27		-	BY repealing and reenacting, with amendments,
28		-	Article – Commercial Law
29		-	Section 13–301(14)(xxxv)
30		-	Annotated Code of Maryland
31		-	(2013 Replacement Volume and 2022 Supplement)
	24	+	AN ACT concerning 1
32	25
33		-	BY repealing and reenacting, without amendments,
34		-	Article – Commercial Law
35		-	Section 13–301(14)(xxxvi)
36		-	Annotated Code of Maryland
37		-	(2013 Replacement Volume and 2022 Supplement)
	26	+	Hospitals – Financial Assistance – Medical Bill Reimbursement Process 2
38	27
39		-	BY adding to
40		-	Article – Commercial Law
41		-	Section 13–301(14)(xxxvii)
42		-	Annotated Code of Maryland
43		-	(2013 Replacement Volume and 2022 Supplement)
	28	+	FOR the purpose of establishing requirements related to the reimbursement of 3
	29	+	out–of–pocket costs paid by certain hospital patients who were eligible for free care, 4
	30	+	including requirements related to the consideration of data and the reporting and 5
	31	+	disclosure of certain information; modifying the process the Health Services Cost 6
	32	+	Review Commission is required to develop for identifying and reimbursing certain 7
	33	+	patients of hospitals; providing that a hospital is not required to provide certain 8
	34	+	reimbursements under certain circumstances; requiring the implementation of a 9
	35	+	certain option from a certain report under certain circumstances; requiring a 10
	36	+	hospital to reimburse certain State government entities for certain costs; making a 11
	37	+	violation of this Act an unfair, abusive, or deceptive trade practice that is subject to 12
	38	+	enforcement and penalties under the Maryland Consumer Protection Act; 13
	39	+	authorizing the State Department of Assessments and Taxation and the Office of the 14
	40	+	Comptroller to disclose tax information to hospitals and certain units for a certain 15
	41	+	purpose; and generally relating to hospitals, financial assistance policies, and 16
	42	+	reimbursement for paid bills. 17
44	43
45		-	BY repealing and reenacting, with amendments,
46		-	Article – ~~Health – General~~
47		-	Section 19–~~214.4~~
48		-	Annotated Code of Maryland
49		-	(~~2019~~ Replacement Volume and 2022 Supplement) ~~Ch. 310~~ ~~2023 LAWS OF MARYLAND~~
	44	+	BY repealing and reenacting, with amendments, 18
	45	+	Article – Commercial Law 19
	46	+	Section 13–301(14)(xxxv) 20
	47	+	Annotated Code of Maryland 21
	48	+	(2013 Replacement Volume and 2022 Supplement) 22 2 HOUSE BILL 333
50	49
51		-	– 2 –
52	50
53		-	BY repealing and reenacting, with amendments,
54		-	Article – Tax – General
55		-	Section 13–203(c)
56		-	Annotated Code of Maryland
57		-	(2022 Replacement Volume)
58	51
59		-	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
60		-	That the Laws of Maryland read as follows:
	52	+	BY repealing and reenacting, without amendments, 1
	53	+	Article – Commercial Law 2
	54	+	Section 13–301(14)(xxxvi) 3
	55	+	Annotated Code of Maryland 4
	56	+	(2013 Replacement Volume and 2022 Supplement) 5
61	57
62		-	Article – Commercial Law
	58	+	BY adding to 6
	59	+	Article – Commercial Law 7
	60	+	Section 13–301(14)(xxxvii) 8
	61	+	Annotated Code of Maryland 9
	62	+	(2013 Replacement Volume and 2022 Supplement) 10
63	63
64		-	13–301.
	64	+	BY repealing and reenacting, with amendments, 11
	65	+	Article – Health – General 12
	66	+	Section 19–214.4 13
	67	+	Annotated Code of Maryland 14
	68	+	(2019 Replacement Volume and 2022 Supplement) 15
65	69
66		-	Unfair, abusive, or deceptive trade practices include any:
	70	+	BY repealing and reenacting, with amendments, 16
	71	+	Article – Tax – General 17
	72	+	Section 13–203(c) 18
	73	+	Annotated Code of Maryland 19
	74	+	(2022 Replacement Volume) 20
67	75
68		-	(14) Violation of a provision of:
	76	+	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 21
	77	+	That the Laws of Maryland read as follows: 22
69	78
70		-	~~(xxxv) Section 11–210 of the Education Article; [or]~~
	79	+	Article – Commercial Law 23
71	80
72		-	~~(xxxvi) Title 14, Subtitle 44 of this article; or~~
	81	+	13–301. 24
73	82
74		-	(XXXVII) SECTION 19–214.4 OF THE HEALTH – GENERAL
75		-	ARTICLE BY A HOSPITAL ; OR
	83	+	Unfair, abusive, or deceptive trade practices include any: 25
76	84
77		-	~~Article – Health – General~~
	85	+	(14) Violation of a provision of: 26
78	86
79		-	19–~~214.4.~~
	87	+	(xxxv) Section 11–210 of the Education Article; [or] 27
80	88
81		-	(a) The Commission, in coordination with the DEPARTMENT , THE Department
82		-	of Human Services, [the State designated exchange,] the Office of the Comptroller, THE
83		-	STATE DEPARTMENT OF EDUCATION, THE HEALTH EDUCATION AND ADVOCACY
84		-	UNIT, and the Maryland Hospital Association, shall develop a process that:
	89	+	(xxxvi) Title 14, Subtitle 44 of this article; or 28
85	90
86		-	(1) Identifies the patients who paid MORE THAN $25 for hospital services
87		-	who may have qualified for free care under § 19–214.1 of this subtitle [at the time of care]
88		-	ON THE DATE THE HOSP ITAL SERVICE WAS PRO VIDED during calendar years 2017
89		-	through 2021;
	91	+	(XXXVII) SECTION 19–214.4 OF THE HEALTH – GENERAL 29
	92	+	ARTICLE BY A HOSPITAL ; OR 30
90	93
91		-	(2) Provides reimbursement to the patients identified under item (1) of this
92		-	subsection, which may be applied incrementally;
	94	+	Article – Health – General 31
93	95
94		-	(3) Ensures that a patient’s alternate address is used if the patient
95		-	requested an alternate address for safety reasons; and
96		-	WES MOORE, Governor Ch. 310
	96	+	19–214.4. 32
	97	+	HOUSE BILL 333 3
97	98
98		-	– 3 –
99		-	(4) Determines how the Commission, THE DEPARTMENT, the
100		-	Department of Human Services, [and] the Office of the Comptroller ,
101		-	AND THE STATE DEPARTMENT OF EDUCATION should share with or disclose relevant
102		-	information, including tax information, to the minimum extent necessary, to the hospital
103		-	and in accordance with federal and State confidentiality laws for the purpose of carrying
104		-	out the process developed under this subsection.
105	99
106		-	(B) THE HEALTH EDUCATION ADVOCACY UNIT IN THE OFFICE OF THE
107		-	ATTORNEY GENERAL SHALL ASSIST PATIENTS IDENTIFIED UNDER SUBSECTION (A)
108		-	OF THIS SECTION IN O BTAINING REIMBURSEME NT UNDER THIS SECTIO N.
	100	+	(a) The Commission, in coordination with the DEPARTMENT , THE Department 1
	101	+	of Human Services, [the State designated exchange,] the Office of the Comptroller, THE 2
	102	+	STATE DEPARTMENT OF EDUCATION, THE HEALTH EDUCATION AND ADVOCACY 3
	103	+	UNIT, and the Maryland Hospital Association, shall develop a process that: 4
109	104
110		-	(C) (1) THE PROCESS DEVELOPED UNDER SUBSECTION (A) OF THIS
111		-	SECTION:
	105	+	(1) Identifies the patients who paid MORE THAN $25 for hospital services 5
	106	+	who may have qualified for free care under § 19–214.1 of this subtitle [at the time of care] 6
	107	+	ON THE DATE THE HOSP ITAL SERVICE WAS PRO VIDED during calendar years 2017 7
	108	+	through 2021; 8
112	109
113		-	(I) SHALL REQUIRE EACH HO SPITAL TO CONSIDER :
	110	+	(2) Provides reimbursement to the patients identified under item (1) of this 9
	111	+	subsection, which may be applied incrementally; 10
114	112
115		-	~~1. TAX DATA FROM~~ THE ~~OFFICE OF THE COMPTROLLER~~
116		-	~~AS DE FACTO EVIDENC E OF A PATIENT’S INCOME~~; AND
	113	+	(3) Ensures that a patient’s alternate address is used if the patient 11
	114	+	requested an alternate address for safety reasons; and 12
117	115
118		-	2. DATA FROM THE DEPARTMENT , THE DEPARTMENT
119		-	OF HUMAN SERVICES, AND THE STATE DEPARTMENT OF EDUCATION AS DE FACTO
120		-	EVIDENCE OF A PATIEN T’S PRESUMPTIVE ELIGIB ILITY FOR FREE CARE ;
	116	+	(4) Determines how the Commission, THE DEPARTMENT , the 13
	117	+	Department of Human Services, [and] the Office of the Comptroller , 14
	118	+	AND THE STATE DEPARTMENT OF EDUCATION should share with or disclose relevant 15
	119	+	information, including tax information, to the minimum extent necessary, to the hospital 16
	120	+	and in accordance with federal and State confidentiality laws for the purpose of carrying 17
	121	+	out the process developed under this subsection. 18
121	122
122		-	(II) SHALL REQUIRE EACH HO SPITAL TO PROVIDE REFUNDS TO
123		-	PATIENTS WHO QUALIFY UNDER SUBSECTION (G)(2) OF THIS SECTION; AND
	123	+	(B) THE HEALTH EDUCATION ADVOCACY UNIT IN THE OFFICE OF THE 19
	124	+	ATTORNEY GENERAL SHALL ASSIST PATIENTS IDENTIFIED UNDER SUBSECTION (A) 20
	125	+	OF THIS SECTION IN O BTAINING REIMBURSEME NT UNDER THIS SECTION . 21
124	126
125		-	(III) MAY NOT REQUIRE A HOS PITAL TO PROVIDE A P ATIENT
126		-	WITH A REFUND IF THE PATIENT PREVIOUSLY W AS DENIED FREE CARE BECAUSE OF
127		-	A FAILED ASSET TEST FOR THE IDENTIFIED D ATE OF SERVICE.
	127	+	(C) (1) THE PROCESS DEVELOPED UNDER SUBSECTION (A) OF THIS 22
	128	+	SECTION: 23
128	129
129		-	(2) EACH ~~HOSPITAL SHALL C REATE A WEBPAGE THAT INCLUDES~~:
	130	+	(I) SHALL REQUIRE EACH HO SPITAL TO CONSIDER : 24
130	131
131		-	(I) INFORMATION ABOUT THE REIMBURSEMENT PROVID ED IN
132		-	ACCORDANCE WITH THIS SECTION, INCLUDING THE PROCES S TO BE FOLLOWED BY
133		-	A PATIENT AND RELEVA NT TIMELINES; AND
	132	+	1. TAX DATA FROM THE OFFICE OF THE COMPTROLLER 25
	133	+	AS DE FACTO EVIDENCE OF A PATIENT’S INCOME; AND 26
134	134
135		-	~~(II) A TELEPHONE NUMBER AND E–MAIL ADDRESS THAT A~~
136		-	~~PATIENT MAY USE TO S UBMIT QUESTIONS ABOU T~~ THE ~~REIMBURSEMENT PROCESS~~
137		-	~~DEVELOPED UNDER THIS SECTION.~~
	135	+	2. DATA FROM THE DEPARTMENT , THE DEPARTMENT 27
	136	+	OF HUMAN SERVICES, AND THE STATE DEPARTMENT OF EDUCATION AS DE FACTO 28
	137	+	EVIDENCE OF A PATIEN T’S PRESUMPTIVE ELIGIB ILITY FOR FREE CARE ; 29
138	138
139		-	(3) IF A PATIENT IS ENTITLED TO A SINGLE REFU ND PER YEAR UNDER
140		-	SUBSECTION (A) OF THIS SECTION IN A N AMOUNT OF $25 OR LESS, THE HOSPITAL
141		-	MAY BUT IS NOT REQUI RED TO PROVIDE THE R EIMBURSEMENT .
142		-	Ch. 310 2023 LAWS OF MARYLAND
	139	+	(II) SHALL REQUIRE EACH HO SPITAL TO PROVIDE RE FUNDS TO 30
	140	+	PATIENTS WHO QUALIFY UNDER SUBSECTION (G)(2) OF THIS SECTION; AND 31
143	141
144		-	~~– 4 –~~
145		-	~~[(b)] (D) (1)~~ The ~~Commission may modify the process developed under~~
146		-	~~subsection (a)~~ of ~~this section as necessary~~.
	142	+	(III) MAY NOT REQUIRE A HOS PITAL TO PROVIDE A P ATIENT 32
	143	+	WITH A REFUND IF THE PATIENT PREVIOUSLY W AS DENIED FREE CARE BECAUSE OF 33
	144	+	A FAILED ASSET TEST FOR THE IDENTIFIED D ATE OF SERVICE. 34 4 HOUSE BILL 333
147	145
148		-	(2) IF REIMBURSEMENTS ARE PROVIDED INCREMENTAL LY AND LESS
149		-	THAN 10% 5% OF THE ESTIMATED REI MBURSEMENTS ARE MADE EACH YEAR DURING
150		-	THE FIRST INCREMENT , THE COMMISSION IS NOT REQ UIRED TO IMPLEMENT
151		-	ADDITIONAL INCREMENT S OF THE PROCESS .
152	146
153		-	(E) THE DEPARTMENT , THE DEPARTMENT OF HUMAN SERVICES, THE
154		-	OFFICE OF THE COMPTROLLER , THE STATE DEPARTMENT OF EDUCATION, AND
155		-	EACH HOSPITAL SHALL REPORT INFORMATION O N THE PROCESS DEVELO PED
156		-	UNDER THIS SECTION T O THE COMMISSION, IN THE TIME AND MANN ER
157		-	DETERMINED BY THE COMMISSION.
158	147
159		-	(F) (1) NOTWITHSTANDING ANY O THER PROVISION OF LAW, THE
160		-	COMMISSION, THE DEPARTMENT , THE DEPARTMENT OF HUMAN SERVICES, THE
161		-	OFFICE OF THE COMPTROLLER , THE STATE DEPARTMENT OF EDUCATION, AND
162		-	EACH HOSPITAL SHALL DISCLOSE TO EACH:
	148	+	(2) EACH HOSPITAL SHALL C REATE A WEBPAGE THAT IN CLUDES: 1
163	149
164		-	(I) EACH OTHER, TO THE MINIMUM EXTEN T NECESSARY ,
165		-	RELEVANT INFORMATION , INCLUDING TAX INFORMAT ION, NECESSARY FOR
166		-	IMPLEMENTATION OF TH E PROCESS DEVELOPED UNDER SUBSECTION (A) OF THIS
167		-	SECTION; AND
	150	+	(I) INFORMATION ABOUT THE REIMBURSEMENT PROVID ED IN 2
	151	+	ACCORDANCE WITH THIS SECTION, INCLUDING THE PROCES S TO BE FOLLOWED BY 3
	152	+	A PATIENT AND RELEVA NT TIMELINES; AND 4
168	153
169		-	(II) THE HEALTH EDUCATION AND ADVOCACY UNIT RELEVANT
170		-	INFORMATION NECESSAR Y FOR THE HEALTH EDUCATION AND ADVOCACY UNIT TO
171		-	ASSIST PATIENTS IN OBTAINING R EIMBURSEMENT UNDER S UBSECTION (A) OF THIS
172		-	SECTION, ON RECEIPT OF THE PA TIENT’S EXECUTED AUTHORIZA TION FOR RELEASE
173		-	OF MEDICAL INFORMATI ON FORM PROVIDED BY THE HEALTH EDUCATION AND
174		-	ADVOCACY UNIT OR OTHER AUTHORI ZATION FORM REQUIRED BY THE
175		-	DEPARTMENT OF HUMAN SERVICES, THE OFFICE OF THE COMPTROLLER , OR THE
176		-	STATE DEPARTMENT OF EDUCATION.
	154	+	(II) A TELEPHONE NUMBER AND E–MAIL ADDRESS THAT A 5
	155	+	PATIENT MA Y USE TO SUBMIT QUES TIONS ABOUT THE REIM BURSEMENT PROCESS 6
	156	+	DEVELOPED UNDER THIS SECTION. 7
177	157
178		-	(2) IF THE HEALTH EDUCATION AND ADVOCACY UNIT REQUESTS
179		-	INFORMATION FROM THE COMMISSION, THE DEPARTMENT , THE DEPARTMENT OF
180		-	HUMAN SERVICES, THE OFFICE OF THE COMPTROLLER , THE STATE DEPARTMENT
181		-	OF EDUCATION, OR A HOSPITAL TO ASS IST A PATIENT IN OBT AINING
182		-	REIMBURSEMENT UNDER SUBSECTION (A) OF THIS SECTION, THE COMMISSION, THE
183		-	DEPARTMENT , THE DEPARTMENT OF HUMAN SERVICES, THE OFFICE OF THE
184		-	COMPTROLLER , THE STATE DEPARTMENT OF EDUCATION, OR THE HOSPITAL
185		-	SHALL PROVIDE THE IN FORMATION TO THE HEALTH EDUCATION AND ADVOCACY
186		-	UNIT WITHIN 10 BUSINESS DAYS AFTER THE DATE OF THE RECE IPT OF THE
187		-	REQUEST. WES MOORE, Governor Ch. 310
	158	+	(3) IF A PATIENT IS ENTITLED TO A SINGLE REFU ND PER YEAR UNDER 8
	159	+	SUBSECTION (A) OF THIS SECTION IN A N AMOUNT OF $25 OR LESS, THE HOSPITAL 9
	160	+	MAY BUT IS NOT REQUI RED TO PROVIDE THE REIMBURSEM ENT. 10
188	161
189		-	– 5 –
	162	+	[(b)] (D) (1) The Commission may modify the process developed under 11
	163	+	subsection (a) of this section as necessary. 12
190	164
191		-	(2) ~~(3) THIS SECTION MAY NOT BE CONSTRUED TO MAKE A~~
192		-	~~HOSPITAL RESPONSIBLE FOR~~ THE ~~CONFIDENTIALITY OF T HE INFORMATION IN~~
193		-	~~POSSESSION OF EACH STATE ENTITY LISTED I N PARAGRAPH (1) OF THIS~~
194		-	~~SUBSECTION~~.
	165	+	(2) IF REIMBURSEMENTS ARE PROVIDED INCREMENTAL LY AND LESS 13
	166	+	THAN 10% 5% OF THE ESTIMATED REI MBURSEMENTS ARE MADE EACH YEAR DURING 14
	167	+	THE FIRST INCREMENT , THE COMMISSION IS NOT REQ UIRED TO IMPLEMENT 15
	168	+	ADDITIONAL INCREMENT S OF THE PROCESS . 16
195	169
196		-	~~[(c)]~~ (G) ~~(1) (I) On or before January 1~~, ~~2023~~, ~~and [January~~ ~~1] OCTOBER~~
197		-	~~1, 2024~~, the ~~Commission shall report to the Senate Finance Committee~~ and ~~the House~~
198		-	~~Health and Government Operations Committee,~~ ~~in accordance with § 2–1257 of~~ the ~~State~~
199		-	~~Government Article,~~ on the ~~development~~ and ~~implementation by hospitals of the process~~
200		-	~~required under subsection (a) of this section~~.
	170	+	(E) THE DEPARTMENT , THE DEPARTMENT OF HUMAN SERVICES, THE 17
	171	+	OFFICE OF THE COMPTROLLER , THE STATE DEPARTMENT OF EDUCATION, AND 18
	172	+	EACH HOSPI TAL SHALL REPORT INF ORMATION ON THE PROC ESS DEVELOPED 19
	173	+	UNDER THIS SECTION T O THE COMMISSION, IN THE TIME AND MANN ER 20
	174	+	DETERMINED BY THE COMMISSION. 21
201	175
202		-	~~[(2)]~~ (II) If the ~~process developed under subsection (a) of this section~~
203		-	~~requires legislation for implementation~~, the ~~Commission shall include~~ the ~~legislative~~
204		-	~~recommendations in~~ the ~~report required on or before January 1~~, ~~2023~~, ~~under [paragraph~~
205		-	~~(1)] SUBPARAGRAPH (I) of this [subsection] PARAGRAPH .~~
	176	+	(F) (1) NOTWITHSTANDING ANY O THER PROVISION OF LA W, THE 22
	177	+	COMMISSION, THE DEPARTMENT , THE DEPARTMENT OF HUMAN SERVICES, THE 23
	178	+	OFFICE OF THE COMPTROLLER , THE STATE DEPARTMENT OF EDUCATION, AND 24
	179	+	EACH HOSPITAL SHALL DISCLOSE TO EACH: 25
206	180
207		-	[(3)] (III) If the process established under subsection (a) of this section does
208		-	not require legislation, each hospital shall implement the process developed under
209		-	subsection (a) of this section on or before January 1, 2023.
	181	+	(I) EACH OTHER, TO THE MINIMUM EXTEN T NECESSARY , 26
	182	+	RELEVANT INFORMATION , INCLUDING TAX INFORM ATION, NECESSARY FOR 27
	183	+	IMPLEMENTATION OF TH E PROCESS DEVELOPED UND ER SUBSECTION (A) OF THIS 28
	184	+	SECTION; AND 29
210	185
211		-	(2) (I) SUBJECT TO SUBPARAGRA PH (II) OF THIS PARAGRAPH ,
212		-	EACH HOSPITAL THE COMMISSION, THE OFFICE OF THE COMPTROLLER , THE
213		-	DEPARTMENT , THE DEPARTMENT OF HUMAN SERVICES, AND THE STATE
214		-	DEPARTMENT OF EDUCATION SHALL IMPLE MENT OPTION 3 FROM THE “FREE
215		-	HOSPITAL CARE REFUND PROCESS” REPORT SUBMITTED BY THE COMMISSION IN
216		-	DECEMBER 2022 AS REQUIRED UNDER PA RAGRAPH (1)(I) OF THIS SUBSECTION A ND
217		-	IN ACCORDANCE WITH T HIS SECTION AND § 12–203(C) § 13–203(C) OF THE TAX –
218		-	GENERAL ARTICLE.
	186	+	(II) THE HEALTH EDUCATION AND ADVOCACY UNIT RELEVANT 30
	187	+	INFORMATION NECESSAR Y FOR THE HEALTH EDUCATION AND ADVOCACY UNIT TO 31
	188	+	ASSIST PATIENTS IN O BTAINING REIMBURSEME NT UNDER SUBSECTION (A) OF THIS 32
	189	+	SECTION, ON RECEIPT OF THE PA TIENT’S EXECUTED AUTHORIZA TION FOR RELEASE 33
	190	+	OF MEDICAL INFORMATI ON FORM PROVIDED BY THE HEALTH EDUCATION AND 34 HOUSE BILL 333 5
219	191
220		-	(II) UNDER THE PROCESS REQ UIRED UNDER SUBPARAGRAPH
221		-	(I) OF THIS PARAGRAPH , A PATIENT SHALL QUAL IFY FOR REFUNDS WHO PAID AN
222		-	OUT–OF–POCKET EXPENSE FOR S ERVICES BASED ON THE FOLLOWING:
223	192
224		-	1. THE ~~OFFICE OF THE COMPTROLLER DETERMINI NG~~
225		-	~~THAT~~ THE ~~PATIENT ’S FAMILY INCOME WAS AT OR BELOW 200%~~ OF THE ~~FEDERAL~~
226		-	~~POVERTY LEVEL DURING THE YEAR~~ OF ~~SERVICE DATE OR DATES ; OR~~
	193	+	ADVOCACY UNIT OR OTHER AUTHORI ZATION FORM REQUIRED BY THE 1
	194	+	DEPARTMENT OF HUMAN SERVICES, THE OFFICE OF THE COMPTROLLER , OR THE 2
	195	+	STATE DEPARTMENT OF EDUCATION. 3
227	196
228		-	2. THE DEPARTMENT OF HUMAN SERVICES, THE
229		-	DEPARTMENT , OR THE STATE DEPARTMENT OF EDUCATION DETERMINING THAT
230		-	DURING THE YEAR OF S ERVICE DATE OR DATES , THE PATIENT:
	197	+	(2) IF THE HEALTH EDUCATION AND ADVOCACY UNIT REQUESTS 4
	198	+	INFORMATION FROM THE COMMISSION, THE DEPARTMENT , THE DEPARTMENT OF 5
	199	+	HUMAN SERVICES, THE OFFICE OF THE COMPTROLLER , THE STATE DEPARTMENT 6
	200	+	OF EDUCATION, OR A HOSPIT AL TO ASSIST A PATIE NT IN OBTAINING 7
	201	+	REIMBURSEMENT UNDER SUBSECTION (A) OF THIS SECTION, THE COMMISSION, THE 8
	202	+	DEPARTMENT , THE DEPARTMENT OF HUMAN SERVICES, THE OFFICE OF THE 9
	203	+	COMPTROLLER , THE STATE DEPARTMENT OF EDUCATION, OR THE HOSPITAL 10
	204	+	SHALL PROVIDE THE IN FORMATION TO THE HEALTH EDUCATION AND ADVOCACY 11
	205	+	UNIT WITHIN 10 BUSINESS DAYS AFTER THE DATE OF THE RECE IPT OF THE 12
	206	+	REQUEST. 13
231	207
232		-	A. RECEIVED BENEFI TS THROUGH THE FEDER AL
233		-	SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM; Ch. 310 2023 LAWS OF MARYLAND
	208	+	(2) (3) THIS SECTION MAY NOT BE CONSTRUED TO MAKE A 14
	209	+	HOSPITAL RESPONSIBLE FOR THE CONFIDENTIAL ITY OF THE INFORMATI ON IN 15
	210	+	POSSESSION OF EACH STATE ENTITY LISTED I N PARAGRAPH (1) OF THIS 16
	211	+	SUBSECTION. 17
234	212
235		-	– 6 –
	213	+	[(c)] (G) (1) (I) On or before January 1, 2023, and [January 1] OCTOBER 18
	214	+	1, 2024, the Commission shall report to the Senate Finance Committee and the House 19
	215	+	Health and Government Operations Committee, in accordance with § 2–1257 of the State 20
	216	+	Government Article, on the development and implementation by hospitals of the process 21
	217	+	required under subsection (a) of this section. 22
236	218
237		-	B. RECEIVED BENEFITS THR OUGH THE STATE’S
238		-	ENERGY ASSISTANCE PROGRAM;
	219	+	[(2)] (II) If the process developed under subsection (a) of this section 23
	220	+	requires legislation for implementation, the Commission shall include the legislative 24
	221	+	recommendations in the report required on or before January 1, 2023, under [paragraph 25
	222	+	(1)] SUBPARAGRAPH (I) of this [subsection] PARAGRAPH . 26
239	223
240		-	~~C. RECEIVED BENEFITS THR OUGH~~ THE ~~FEDERAL~~
241		-	~~SPECIAL SUPPLEMENTAL FOOD PROGRAM FOR WOMEN~~, ~~INFANTS, AND CHILDREN;~~
242		-	OR
	224	+	[(3)] (III) If the process established under subsection (a) of this section does 27
	225	+	not require legislation, each hospital shall implement the process developed under 28
	226	+	subsection (a) of this section on or before January 1, 2023. 29
243	227
244		-	D. LIVED IN A HOUSEHOLD WITH CHILDREN ENROLL ED
245		-	IN THE FREE AND REDU CED–COST MEAL PROGRAM .
	228	+	(2) (I) SUBJECT TO SUBPARAGRA PH (II) OF THIS PARAGR APH, 30
	229	+	EACH HOSPITAL THE COMMISSION, THE OFFICE OF THE COMPTROLLER , THE 31
	230	+	DEPARTMENT , THE DEPARTMENT OF HUMAN SERVICES, AND THE STATE 32
	231	+	DEPARTMENT OF EDUCATION SHALL IMPLE MENT OPTION 3 FROM THE “FREE 33
	232	+	HOSPITAL CARE REFUND PROCESS” REPORT SUBMITTED BY THE COMMISSION IN 34
	233	+	DECEMBER 2022 AS REQUIRED UNDER PA RAGRAPH (1)(I) OF THIS SUBSECTION A ND 35
	234	+	IN ACCORDANCE WITH T HIS SECTION AND § 12–203(C) § 13–203(C) OF THE TAX – 36
	235	+	GENERAL ARTICLE. 37
	236	+	6 HOUSE BILL 333
246	237
247		-	(3) THE OFFICE OF THE COMPTROLLER , THE DEPARTMENT OF
248		-	HUMAN SERVICES, THE DEPARTMENT , THE STATE DEPARTMENT OF EDUCATION,
249		-	THE COMMISSION, AND EACH HOSPITAL MA Y NOT IMPLEMENT THE ALTERNATIVE
250		-	APPROACH INCLUDED WI TH OPTION 3 IN THE REPORT IDENTI FIED UNDER
251		-	PARAGRAPH (2)(I) OF THIS SUBSECTION .
252	238
253		-	(H) (1) EACH HOSPITAL SHALL R EIMBURSE THE COMMISSION, THE
254		-	OFFICE OF THE COMPTROLLER , THE DEPARTMENT , THE DEPARTMENT OF HUMAN
255		-	SERVICES, THE STATE DEPARTMENT OF EDUCATION, AND THE HEALTH
256		-	EDUCATION ADVOCACY UNIT IN THE OFFICE OF THE ATTORNEY GENERAL FOR THE
257		-	COSTS INCURRED BY EA CH STATE ENTITY IN COMPL YING WITH THIS SECTI ON.
	239	+	(II) UNDER THE PROCESS REQ UIRED UNDER SUBPARAG RAPH 1
	240	+	(I) OF THIS PARAGRAPH , A PATIENT SHALL QUALIFY FOR RE FUNDS WHO PAID AN 2
	241	+	OUT–OF–POCKET EXPENSE FOR S ERVICES BASED ON THE FOLLOWING: 3
258	242
259		-	(2) (I) REIMBURSEMENT REQUIRE D UNDER PARAGRAPH (1) OF
260		-	THIS SUBSECTION SHAL L BE BASED ON THE HO SPITAL’S PROPORTION OF THE TOTAL
261		-	NUMBER OF PATIENTS W HO WERE IDENTIFIED B Y THE STATE ENTITY AS
262		-	POTENTIALLY ELIGIBLE FOR REIMBURSEMENT IN A DESIGNATED YEAR , AS
263		-	DETERMINED BY THE COMMISSION.
	243	+	1. THE OFFICE OF THE COMPTROLLER DETERMINI NG 4
	244	+	THAT THE PATIENT ’S FAMILY INCOME WAS AT OR BELOW 200% OF THE FEDERAL 5
	245	+	POVERTY LEVEL DURING THE YEAR OF SERVICE DATE OR DATES ; OR 6
264	246
265		-	(II) FOR THE PURPOSE OF DETERMINING THE R EIMBURSEMENT
266		-	DUE UNDER SUBPARAGRA PH (I) OF THIS PARAGRAPH , THE STATE ENTITIES
267		-	IDENTIFIED UNDER PAR AGRAPH (1) OF THIS SUBSECTION S HALL PROVIDE
268		-	QUARTERLY COST INFOR MATION TO THE COMMISSION.
	247	+	2. THE DEPARTMENT OF HUMAN SERVICES, THE 7
	248	+	DEPARTMENT , OR THE STATE DEPARTMENT OF EDUCATION DETERMINING THAT 8
	249	+	DURING THE YEAR OF S ERVICE DATE OR DATES , THE PATIENT: 9
269	250
270		-	(3) THE COMMISSION SHALL PROV IDE EACH HOSPITA L WITH THE
271		-	REIMBURSEMENT AMOUNT DUE TO THE APPROPRIA TE STATE ENTITY BASED ON THE
272		-	COSTS INCURRED BY TH E ENTITY IN COMPLYIN G WITH THIS SECTION .
	251	+	A. RECEIVED BENEFITS THR OUGH THE FEDERAL 10
	252	+	SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM; 11
273	253
274		-	(I) (1) (I) IF A HOSPITAL FAILS T O PROVIDE REFUNDS TO PATIENTS
275		-	WHO QUALIFY UNDER SU BSECTION (G)(2) OF THIS SECTION AS REQUIRED , THE
276		-	COMMISSION MAY IMPOSE A FINE NOT EXCEEDING $50,000 PER VIOLATION.
277		-	WES MOORE, Governor Ch. 310
	254	+	B. RECEIVED BENEFITS THR OUGH THE STATE’S 12
	255	+	ENERGY ASSISTANCE PROGRAM; 13
278	256
279		-	– 7 –
280		-	(II) IN DETERMINING THE AM OUNT OF A FINE TO BE IMPOSED
281		-	UNDER SUBPARAGRAPH (I) OF THIS PARAGRAPH , THE COMMISSION SHALL
282		-	CONSIDER THE APPROPR IATENESS OF THE FINE IN RELATION TO THE SEVE RITY OF
283		-	THE VIOLATION.
	257	+	C. RECEIVED BENEFITS THR OUGH THE FEDERAL 14
	258	+	SPECIAL SUPPLEMENTAL FOOD PROGRAM FOR WOMEN, INFANTS, AND CHILDREN; 15
	259	+	OR 16
284	260
285		-	(2) A VIOLATION OF THIS SE CTION BY A HOSPITAL IS:
	261	+	D. LIVED IN A HOUSEHOLD WITH CHILDREN ENROLL ED 17
	262	+	IN THE FREE AND REDU CED–COST MEAL PROGRAM . 18
286	263
287		-	(I) AN UNFAIR, ABUSIVE, OR DECEPTIVE TRADE P RACTICE, AS
288		-	DEFINED UNDER TITLE 13 OF THE COMMERCIAL LAW ARTICLE; AND
	264	+	(3) THE OFFICE OF THE COMPTROLLER , THE DEPARTMENT OF 19
	265	+	HUMAN SERVICES, THE DEPARTMENT , THE STATE DEPARTMENT OF EDUCATION, 20
	266	+	THE COMMISSION, AND EACH HOSPITAL MAY NOT IMPLEMENT THE ALTERN ATIVE 21
	267	+	APPROACH INCLUDED WI TH OPTION 3 IN THE REPORT IDENTI FIED UNDER 22
	268	+	PARAGRAPH (2)(I) OF THIS SUBSECTION . 23
289	269
290		-	(II) SUBJECT TO ENFORCEMEN T AND PENAL TY PROVISIONS OF
291		-	TITLE 13 OF THE COMMERCIAL LAW ARTICLE.
	270	+	(H) (1) EACH HOSPITAL SHALL R EIMBURSE THE COMMISSION, THE 24
	271	+	OFFICE OF THE COMPTROLLER , THE DEPARTMENT , THE DEPARTMENT OF HUMAN 25
	272	+	SERVICES, THE STATE DEPARTMENT OF EDUCATION, AND THE HEALTH 26
	273	+	EDUCATION ADVOCACY UNIT IN THE OFFICE OF THE ATTORNEY GENERAL FOR THE 27
	274	+	COSTS INCURRED BY EA CH STATE ENTITY IN COMPL YING WITH THIS SECTI ON. 28
292	275
293		-	Article – Tax – General
	276	+	(2) (I) REIMBURSEMENT REQUIRE D UNDER PARAGRAPH (1) OF 29
	277	+	THIS SUBSECTION SHAL L BE BASED ON THE HO SPITAL’S PROPORTION OF THE TOTAL 30
	278	+	NUMBER OF PATIENTS W HO WERE IDENTIFIED B Y THE STATE ENTITY AS 31
	279	+	POTENTIALLY ELIGIBLE FOR REIMBURSEMENT IN A DESIGNATED YEAR , AS 32
	280	+	DETERMINED BY THE COMMISSION. 33
	281	+	HOUSE BILL 333 7
294	282
295		-	13–203.
296	283
297		-	(c) Tax information may be disclosed to:
	284	+	(II) FOR THE PURPOSE OF DE TERMINING THE REIMBU RSEMENT 1
	285	+	DUE UNDER SUBPARAGRA PH (I) OF THIS PARAGRAPH , THE STATE ENTITIES 2
	286	+	IDENTIFIED UNDER PAR AGRAPH (1) OF THIS SUBSECTION S HALL PROVIDE 3
	287	+	QUARTERLY COST INFOR MATION TO THE COMMISSION. 4
298	288
299		-	(1) an employee or officer of the State who, by reason of that employment
300		-	or office, has the right to the tax information;
	289	+	(3) THE COMMISSION SHALL PROV IDE EACH HOSPITAL WIT H THE 5
	290	+	REIMBURSEMENT AMOUNT DUE TO THE APPROPRIA TE STATE ENTITY BASED ON THE 6
	291	+	COSTS INCURRED BY TH E ENTITY IN COMPLYIN G WITH THIS SECTION . 7
301	292
302		-	(2) another tax collector;
	293	+	(I) (1) (I) IF A HOSPITAL FAILS T O PROVIDE REFUNDS TO PATIENTS 8
	294	+	WHO QUALIFY UNDER SU BSECTION (G)(2) OF THIS SECTION AS R EQUIRED, THE 9
	295	+	COMMISSION MAY IMPOSE A FINE NOT EXCEEDING $50,000 PER VIOLATION. 10
303	296
304		-	(3) the Maryland Tax Court;
	297	+	(II) IN DETERMINING THE AM OUNT OF A FINE TO BE IMPOSED 11
	298	+	UNDER SUBPARAGRAPH (I) OF THIS PARAGRAPH , THE COMMISSION SHALL 12
	299	+	CONSIDER THE APPROPR IATENESS OF THE FINE IN RELAT ION TO THE SEVERITY OF 13
	300	+	THE VIOLATION. 14
305	301
306		-	(4) a legal representative of the State, to review the tax information about
307		-	a taxpayer:
	302	+	(2) A VIOLATION OF THIS SE CTION BY A HOSPITAL IS: 15
308	303
309		-	(i) who applies for review under this title;
	304	+	(I) AN UNFAIR, ABUSIVE, OR DECEPTIVE TRADE P RACTICE, AS 16
	305	+	DEFINED UNDER TITLE 13 OF THE COMMERCIAL LAW ARTICLE; AND 17
310	306
311		-	(ii) who appeals from a determination under this title; or
	307	+	(II) SUBJECT TO ENFORCEMENT AND PENA LTY PROVISIONS OF 18
	308	+	TITLE 13 OF THE COMMERCIAL LAW ARTICLE. 19
312	309
313		-	(iii) against whom an action to recover tax or a penalty is pending or
314		-	will be initiated under this title;
	310	+	Article – Tax – General 20
315	311
316		-	(5) any license issuing authority of the State required by State law to verify
317		-	through the Comptroller that an applicant has pa id all undisputed taxes and
318		-	unemployment insurance contributions payable to the Comptroller or the Secretary of
319		-	Labor or that the applicant has provided for payment in a manner satisfactory to the unit
320		-	responsible for collection;
	312	+	13–203. 21
321	313
322		-	(6) a local official as defined in § 13–925 of this title to the extent necessary
323		-	to administer Subtitle 9, Part V of this title;
324		-	Ch. 310 2023 LAWS OF MARYLAND
	314	+	(c) Tax information may be disclosed to: 22
325	315
326		-	– 8 –
327		-	(7) a federal official as defined in § 13–930 of this title to the extent
328		-	necessary to administer Subtitle 9, Part VI of this title;
	316	+	(1) an employee or officer of the State who, by reason of that employment 23
	317	+	or office, has the right to the tax information; 24
329	318
330		-	(8) the Maryland Department of Health in accordance with the federal
331		-	Children’s Health Insurance Program Reauthorization Act of 2009;
	319	+	(2) another tax collector; 25
332	320
333		-	(9) the ~~State Board of Individual~~ Tax ~~Preparers~~;
	321	+	(3) the Maryland Tax Court; 26
334	322
335		-	(10) the Alcohol and Tobacco Commission;
	323	+	(4) a legal representative of the State, to review the tax information about 27
	324	+	a taxpayer: 28
336	325
337		-	(11) ~~the Maryland 9–1–1 Board~~; ~~[and]~~
	326	+	(i) who applies for review under this title; 29
338	327
339		-	(12) a person or governmental entity authorized by the Comptroller in
340		-	writing to receive tax information for the purpose of identifying, preventing, or responding
341		-	to fraud, provided that the tax information is:
	328	+	(ii) who appeals from a determination under this title; or 30 8 HOUSE BILL 333
342	329
343		-	(i) anonymized to the extent poss ible consistent with the
344		-	information’s intended use; and
345	330
346		-	(ii) in addition to any other protections and safeguards under law,
347		-	subject to any protections and safeguards set forth by the Comptroller in the written
348		-	authorization; [and]
349	331
350		-	(13) the Maryland Higher Education Commission; AND
	332	+	(iii) against whom an action to recover tax or a penalty is pending or 1
	333	+	will be initiated under this title; 2
351	334
352		-	(14) A HOSPITAL, THE HEALTH SERVICES COST REVIEW COMMISSION,
353		-	THE DEPARTMENT OF HUMAN SERVICES, THE MARYLAND DEPARTMENT OF
354		-	HEALTH, AND THE STATE DEPARTMENT OF EDUCATION, TO THE EXTENT
355		-	NECESSARY TO ADMINIS TER § 19–214.4 OF THE HEALTH – GENERAL ARTICLE.
	335	+	(5) any license issuing authority of the State required by State law to verify 3
	336	+	through the Comptroller that an applicant has paid all undisputed taxes and 4
	337	+	unemployment insurance contributions payable to the Comptroller or the Secretary of 5
	338	+	Labor or that the applicant has provided for payment in a manner satisfactory to the unit 6
	339	+	responsible for collection; 7
356	340
357		-	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July
358		-	1, 2023. It shall remain effective until the taking effect of the termination provision
359		-	specified in Section 2 of Chapter 683 of the Acts of the General Assembly of 2022. If that
360		-	termination provision takes effect, this Act shall be abrogated and of no further force and
361		-	effect. This Act may not be interpreted to have any effect on that termination provision.
	341	+	(6) a local official as defined in § 13–925 of this title to the extent necessary 8
	342	+	to administer Subtitle 9, Part V of this title; 9
362	343
363		-	Approved by the Governor, May 3, 2023.
	344	+	(7) a federal official as defined in § 13–930 of this title to the extent 10
	345	+	necessary to administer Subtitle 9, Part VI of this title; 11
	346	+
	347	+	(8) the Maryland Department of Health in accordance with the federal 12
	348	+	Children’s Health Insurance Program Reauthorization Act of 2009; 13
	349	+
	350	+	(9) the State Board of Individual Tax Preparers; 14
	351	+
	352	+	(10) the Alcohol and Tobacco Commission; 15
	353	+
	354	+	(11) the Maryland 9–1–1 Board; [and] 16
	355	+
	356	+	(12) a person or governmental entity authorized by the Comptroller in 17
	357	+	writing to receive tax information for the purpose of identifying, preventing, or responding 18
	358	+	to fraud, provided that the tax information is: 19
	359	+
	360	+	(i) anonymized to the extent possible consistent with the 20
	361	+	information’s intended use; and 21
	362	+
	363	+	(ii) in addition to any other protections and safeguards under law, 22
	364	+	subject to any protections and safeguards set forth by the Comptroller in the written 23
	365	+	authorization; [and] 24
	366	+
	367	+	(13) the Maryland Higher Education Commission; AND 25
	368	+
	369	+	(14) A HOSPITAL, THE HEALTH SERVICES COST REVIEW COMMISSION, 26
	370	+	THE DEPARTMENT OF HUMAN SERVICES, THE MARYLAND DEPARTMENT OF 27
	371	+	HEALTH, AND THE STATE DEPARTMENT OF EDUCATION, TO THE EXTENT 28
	372	+	NECESSARY TO ADMI NISTER § 19–214.4 OF THE HEALTH – GENERAL ARTICLE. 29
	373	+
	374	+	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 30
	375	+	1, 2023. It shall remain effective until the taking effect of the termination provision 31
	376	+	specified in Section 2 of Chapter 683 of the Acts of the General Assembly of 2022. If that 32 HOUSE BILL 333 9
	377	+
	378	+
	379	+	termination provision takes effect, this Act shall be abrogated and of no further force and 1
	380	+	effect. This Act may not be interpreted to have any effect on that termination provision. 2
	381	+
	382	+
	383	+
	384	+
	385	+
	386	+	Approved:
	387	+	________________________________________________________________________________
	388	+	Governor.
	389	+	________________________________________________________________________________
	390	+	Speaker of the House of Delegates.
	391	+	________________________________________________________________________________
	392	+	President of the Senate.