Maryland 2024 Regular Session

Maryland Senate Bill SB1175 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2
3	3	EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
4	4	[Brackets] indicate matter deleted from existing law.
5	5	sb1175
6	6
7	7	SENATE BILL 1175
8	8	J3, J1 4lr3318
9	9
10	10	By: Senator Lam
11	11	Introduced and read first time: February 15, 2024
12	12	Assigned to: Rules
13	13
14	14	A BILL ENTITLED
15	15
16	16	AN ACT concerning 1
17	17
18	18	Hospitals – Emergency Medical Conditions – Procedures 2
19	19	(Maryland Lifesaving Treatment Access and Abortion Protection Act) 3
20	20
21	21	FOR the purpose of requiring a hospital to conduct screening on an individual presenting 4
22	22	at an emergency department of the hospital to determine whether the individual has 5
23	23	an emergency medical condition; establishing requirements and prohibitions related 6
24	24	to the treatment and transfer of an individual who has an emergency medical 7
25	25	condition; prohibiting a hospital from taking adverse action against a provider for 8
26	26	not transferring a patient who is not stabilized or against a hospital employee if the 9
27	27	employee reports a violation of this Act; and generally relating to emergency medical 10
28	28	conditions and hospitals. 11
29	29
30	30	BY adding to 12
31	31	Article – Health – General 13
32	32	Section 19–342.1 14
33	33	Annotated Code of Maryland 15
34	34	(2023 Replacement Volume) 16
35	35
36	36	BY repealing and reenacting, with amendments, 17
37	37	Article – Health – General 18
38	38	Section 20–214(b) 19
39	39	Annotated Code of Maryland 20
40	40	(2023 Replacement Volume) 21
41	41
42	42	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 22
43	43	That the Laws of Maryland read as follows: 23
44	44
45	45	Article – Health – General 24
46	46
47	47	19–342.1. 25 2 SENATE BILL 1175
48	48
49	49
50	50
51	51	(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS 1
52	52	INDICATED. 2
53	53
54	54	(2) “EMERGENCY MEDICAL CONDITION” MEANS: 3
55	55
56	56	(I) A MEDICAL CONDITION THAT PRESENTS THROUG H ACUTE 4
57	57	SYMPTOMS OF SUFFICIE NT SEVERITY, INCLUDING SEVERE PAI N, AND FOR WHICH 5
58	58	THE ABSENCE OF IMMED IATE MEDICAL ATTENTI ON COULD BE REASONAB LY 6
59	59	EXPECTED TO RESULT I N: 7
60	60
61	61	1. PLACING THE HEALTH OF THE INDIVIDUAL OR , WITH 8
62	62	RESPECT TO A PREGNAN T WOMAN, THE HEALTH OF THE WO MAN OR HER UNBORN 9
63	63	CHILD, IN SERIOUS JEOPARDY ; 10
64	64
65	65	2. SERIOUS IMPAIRMENT TO BODILY FUNCTIONS ; OR 11
66	66
67	67	3. SERIOUS DYSFUNCTION O F ANY BODILY ORGAN O R 12
68	68	BODY PART; OR 13
69	69
70	70	(II) WITH RESPECT TO A PREGNANT W OMAN WHO IS HAVING 14
71	71	CONTRACTIONS : 15
72	72
73	73	1. THERE BEING INADEQUAT E TIME TO EFFECT A S AFE 16
74	74	TRANSFER TO ANOTHER HOSPITAL BEFORE DELI VERY; OR 17
75	75
76	76	2. TRANSFER POSING A THR EAT TO THE HEALTH OR 18
77	77	SAFETY OF THE WOMAN OR UNBORN CHILD . 19
78	78
79	79	(3) “STABILIZE” MEANS: 20
80	80
81	81	(I) FOR AN EMERGENCY MEDI CAL CONDITION AS DEFINED IN 21
82	82	PARAGRAPH (2)(I) OF THIS SUBSECTION, TO PROVIDE THE MEDICAL TREATMENT 22
83	83	NECESSARY TO ENSURE, WITHIN REASONABLE ME DICAL PROBABILITY , THAT NO 23
84	84	MATERIAL DETERIORATI ON OF THE CONDITION IS LIKELY TO RESULT FRO M OR 24
85	85	OCCUR DURING THE TRA NSFER OF THE INDIVID UAL FROM THE FACILIT Y; OR 25
86	86
87	87	(II) FOR AN EMERGENCY MEDI CAL CONDITION AS DEFINED IN 26
88	88	PARAGRAPH (2)(II) OF THIS SUBSECTION, THE WOMAN HAS DELIVE RED THE 27
89	89	NEWBORN, INCLUDING DELIVERY O F THE PLACEN TA. 28
90	90
91	91	(B) THIS SECTION APPLIES ONLY TO A HOSPITAL W ITH AN EMERGENCY 29
92	92	DEPARTMENT . 30 SENATE BILL 1175 3
93	93
94	94
95	95
96	96	(C) ON THE REQUEST OF AN INDIVIDUAL PRESENTING AT A HOSP ITAL 1
97	97	EMERGENCY DEPARTMENT , OR THE INDIVIDUAL ’S REPRESENTATIVE , A HOSPITAL 2
98	98	SHALL PROVIDE AN APPROPRIA TE MEDICAL SCREENING TO DETERMINE WHETHER 3
99	99	THE INDIVIDUAL HAS A N EMERGENCY MEDICAL CONDITION. 4
100	100
101	101	(D) IF A HOSPITAL DETERMI NES THAT AN INDIVIDU AL HAS AN EMERGENCY 5
102	102	MEDICAL CONDITION , THE HOSPITAL SHALL : 6
103	103
104	104	(1) USING THE STAFF AND FACILI TIES AVAILABLE AT THE H OSPITAL, 7
105	105	PROVIDE FURTHER EXAM INATION AND THE TREATMENT REQUIRED T O STABILIZE 8
106	106	THE EMERGENCY MEDICA L CONDITION; OR 9
107	107
108	108	(2) TRANSFER THE INDIVIDU AL TO ANOTHER MEDICA L FACILITY. 10
109	109
110	110	(E) (1) A HOSPITAL IS CONSIDER ED TO HAVE MET THE R EQUIREMENTS 11
111	111	OF THIS SECTION IF, AFTER OFFERING FURTH ER EXAMINATION AND T REATMENT OR 12
112	112	TRANSFER TO THE INDI VIDUAL OR THE INDIVI DUAL’S REPRESENTATIVE , AND 13
113	113	INFORMING THE INDIVI DUAL OR INDIVIDUAL ’S REPRESENTATIVE OF THE RISKS AND 14
114	114	BENEFITS OF FURTHER EXAMINATION AND TREA TMENT OR TRANSFER : 15
115	115
116	116	(I) AN INDIVIDUAL OR THE INDIVIDUAL’S REPRESENTATIVE 16
117	117	REFUSES TO CONSENT T O FURTHER EXAMINATIO N AND TREATMENT ; OR 17
118	118
119	119	(II) AN INDIVIDUAL OR THE INDIVIDUAL’S REPRESENTATIVE 18
120	120	REFUSES TO CONSENT T O A TRANSFER TO ANOT HER MEDICAL FACILITY . 19
121	121
122	122	(2) A HOSPITAL SHALL TAKE REASONABLE STEPS TO SECURE 20
123	123	WRITTEN INFORMED CON SENT TO THE REFUSAL OF AN EXAMINATION OR 21
124	124	TREATMENT OR TRANSFER UNDER THIS SUBSECTIO N FROM THE INDIVIDUAL OR 22
125	125	THE INDIVIDUAL ’S REPRESENTATIVE . 23
126	126
127	127	(F) IF AN INDIVIDUAL HAS AN EMERGENCY MEDICAL CONDITION TH AT HAS 24
128	128	NOT BEEN STABILIZED , THE HOSPITAL MAY NOT TRANSFER THE INDIVID UAL 25
129	129	UNLESS: 26
130	130
131	131	(1) THE TRAN SFERRING HOSPITAL PR OVIDES THE MEDICAL 27
132	132	TREATMENT AVAILABLE AT THE HOS PITAL THAT MINIMIZES THE RISKS TO THE 28
133	133	INDIVIDUAL’S HEALTH AND , IN THE CASE OF A WOM AN IN LABOR, THE HEALTH OF 29
134	134	THE UNBORN CHILD ; 30
135	135
136	136	(2) THE RECEIVING FACILIT Y HAS AVAILABLE SPACE AND QUALIFIED 31
137	137	PERSONNEL TO TREAT THE INDIVIDUAL AND HAS AGREED TO ACCEPT THE 32 4 SENATE BILL 1175
138	138
139	139
140	140	TRANSFER O F THE INDIVIDUAL AND TO PROV IDE APPROPRIATE MEDIC AL 1
141	141	TREATMENT ; 2
142	142
143	143	(3) THE TRANSFERRING HOSP ITAL PROVIDES TO THE RECEIVING 3
144	144	FACILITY ALL MEDICAL RECORDS OR COPIES OF MEDICAL RECORDS RELATING TO: 4
145	145
146	146	(I) THE INDIVIDUAL’S EMERGENCY MEDICAL CONDITION; 5
147	147
148	148	(II) OBSERVATION OF SIGNS AND SYMPTOMS ; 6
149	149
150	150	(III) PRELIMINARY DIAGNOSIS ; 7
151	151
152	152	(IV) TREATMENT PROVIDED ; 8
153	153
154	154	(V) TEST RESULTS; 9
155	155
156	156	(VI) THE INFORMED WRITTEN CONSENT AND CERTIFIC ATION 10
157	157	REQUIRED UNDER ITEM (5) OF THIS PARAGRAPH ; AND 11
158	158
159	159	(VII) THE NAME AND ADDRESS OF ANY ON–CALL PHYSICIAN WHO 12
160	160	HAS REFUSED OR FAILE D TO APPEAR WITHIN A REASONABLE TIME TO P ROVIDE 13
161	161	NECESSARY STABILIZIN G TREATMENT ; 14
162	162
163	163	(4) THE TRANSFER IS EFFEC TED THROUGH QUALIFIE D PERSONNEL 15
164	164	AND TRANSPORTATION E QUIPMENT, INCLUDING THE U SE OF NECESSARY AND 16
165	165	MEDICALLY APPROPRIAT E LIFE SUPPORT MEASU RES DURING THE TRANS FER; AND 17
166	166
167	167	(5) (I) THE INDIVIDUAL OR THE INDIVIDUAL’S REPRESENTATIVE , 18
168	168	AFTER BEING INFORMED OF THE HOSPITAL ’S RESPONSIBILITIES UNDER THIS 19
169	169	SECTION AND THE RISK S OF TRANSFER , REQUESTS IN WRITING THE TRANSFER TO 20
170	170	ANOTHER FACILITY ; AND 21
171	171
172	172	(II) 1. A PHYSICIAN HAS SIGNED A CERTIFICATION THAT : 22
173	173
174	174	A. STATES THAT BASED ON THE INFORMATION 23
175	175	AVAILABLE AT THE TIM E OF TRANSFER , THE MEDICAL BE NEFITS REASONABLY 24
176	176	EXPECTED FROM THE PR OVISION OF APPROPRIA TE MEDICAL TREATMENT AT 25
177	177	ANOTHER MEDICAL FACI LITY OUTWEIGH THE RI SKS TO THE INDIVIDUA L AND, IN 26
178	178	THE CASE OF LABOR , TO THE UNBORN CHILD FROM EFFECTING THE T RANSFER; AND 27
179	179
180	180	B. CONTAINS A SUMMARY OF THE RISKS AND BENEFITS 28
181	181	OF TRANSFER; OR 29
182	182	SENATE BILL 1175 5
183	183
184	184
185	185	2. IF A PHYSICIAN IS NOT PHYSICALLY PRESENT I N THE 1
186	186	EMERGENCY DEPARTMENT AT THE TIME THE INDI VIDUAL IS TRANSFERRE D, A 2
187	187	QUALIFIED MEDICAL PR OVIDER HAS SIGNED A CERTIFICATION THAT : 3
188	188
189	189	A. STATES THAT BASED ON THE INFO RMATION 4
190	190	AVAILABLE AT THE TIM E OF TRANSFER , THE MEDICAL BENEFITS REASONABLY 5
191	191	EXPECTED FROM THE PR OVISION OF APPROPRIA TE MEDICAL TREATMENT AT 6
192	192	ANOTHER MEDICAL FACI LITY OUTWEIGH THE RI SKS TO THE INDIVIDUA L AND, IN 7
193	193	THE CASE OF LABOR , TO THE UNBORN CHILD FROM EFFECTING THE TRANSFER ; 8
194	194
195	195	B. CONTAINS A SUMMARY OF THE RISKS AND BENEFI TS 9
196	196	OF TRANSFER; AND 10
197	197
198	198	C. IS SUBSEQUENTLY COUNT ERSIGNED BY A PHYSIC IAN 11
199	199	WHO, IN CONSULTATION WITH THE QUALIFIED MEDICA L PROVIDER, HAS MADE THE 12
200	200	DETERMINATION THAT B ASED ON THE INFORMAT ION AVAILABLE AT THE TIME OF 13
201	201	TRANSFER, THE MEDICAL BENEFITS REASONABLY EXPECTED FROM THE PROVISION 14
202	202	OF APPROPRIATE MEDIC AL TREATMENT AT ANOT HER MEDICAL FACILITY 15
203	203	OUTWEIGHED THE RISKS TO THE INDIVIDUAL AN D, IN THE CASE OF LABOR , TO THE 16
204	204	UNBORN CHILD FROM EF FECTING THE TRANSFER . 17
205	205
206	206	(G) IF A PHYSICIAN DETERM INES AFTER THE MEDICAL SCREENIN G THAT AN 18
207	207	INDIVIDUAL REQUIRES THE SERVICES OF A PH YSICIAN ON THE HOSPI TAL’S LIST OF 19
208	208	ON–CALL PHYSICIANS , AND THE ON–CALL PHYSICIAN REFUS ES OR FAILS TO APPEA R 20
209	209	WITHIN A REASONABLE PERIOD OF TIME AFTER NOTIFICATION FROM TH E 21
210	210	PHYSICIAN, THE PHYSICIAN WHO PROVIDED NOTIFICATION TO THE ON–CALL 22
211	211	PHYSICIAN IS NOT LIABLE FOR A PENALTY UNDER THIS S ECTION FOR A TRANSFE R 23
212	212	THAT OTHERWISE MET T HE REQUIREMENTS OF S UBSECTION (F) OF THIS SECTION. 24
213	213
214	214	(H) A HOSPITAL THAT HAS SP ECIALIZED CAPABILITI ES OR FACILITIES OR A 25
215	215	REGIONAL REFE RRAL CENTER MAY NOT REFUSE AN APPROPRIAT E TRANSFER OF AN 26
216	216	INDIVIDUAL WHO REQUI RES THE HOSPITAL ’S SPECIALIZED CAPABILI TIES OR 27
217	217	FACILITIES IF THE HO SPITAL HAS THE CAPAC ITY TO TREAT THE IND IVIDUAL. 28
218	218
219	219	(I) A HOSPITAL MAY NOT DEL AY PROVIDING AN APPROPRIATE MEDIC AL 29
220	220	SCREENING EXAMINATIO N OR FURTHER MEDICAL EXAMINATION TO INQUI RE ABOUT 30
221	221	THE INDIVIDUAL ’S METHOD OF PAYMENT OR INSURANCE STATUS . 31
222	222
223	223	(J) A HOSPITAL MAY NOT PENALIZE OR TAKE OTHER ADVERSE ACTION 32
224	224	AGAINST: 33
225	225	6 SENATE BILL 1175
226	226
227	227
228	228	(1) A QUALIFIED MEDICAL PROVIDER IF THE PROVIDER REFUSES TO 1
229	229	AUTHORIZE THE TRANSF ER OF AN INDIVIDUAL WITH AN EMERGENCY ME DICAL 2
230	230	CONDITION THAT HAS N OT BEEN STABILIZED ; OR 3
231	231
232	232	(2) A HOSPITAL EMPLOYEE IF THE EMPLOYEE REPORTS A VIOLATION 4
233	233	OF THIS SECTION. 5
234	234
235	235	(K) A HOSPITAL THAT NEGLIG ENTLY VIOLATES THIS SE CTION IS SUBJECT 6
236	236	TO A CIVIL PENALTY O F: 7
237	237
238	238	(1) FOR A HOSPITAL WITH 100 OR MORE BEDS , NOT MORE THAN 8
239	239	$50,000 FOR EACH VIOLATION; OR 9
240	240
241	241	(2) FOR A HOSPITAL WITH F EWER THAN 100 BEDS, NOT MORE THAN 10
242	242	$25,000 FOR EACH VIOLATION. 11
243	243
244	244	(L) (1) A PHYSICIAN, INCLUDING AN ON –CALL PHYSICIAN , WHO IS 12
245	245	RESPONSIBLE FOR THE EXAMINATION , TREATMENT , OR TRANSFER OF AN 13
246	246	INDIVIDUAL UNDER THI S SECTION AND WHO NE GLIGENTLY VIOLATES T HIS SECTION 14
247	247	IS SUBJECT TO A CIVIL PENALTY OF NOT MOR E THAN $50,000 FOR EACH VIOLATIO N. 15
248	248
249	249	(2) IF A PHYSICIAN, INCLUDING AN ON –CALL PHYSICIAN , WHO IS 16
250	250	RESPONSIBLE FOR THE EXAMINATION , TREATMENT , OR TRANSFER OF AN 17
251	251	INDIVIDUAL UNDER THI S SECTION IS FOUND T O BE GROSSLY NEGLIGENT IN A 18
252	252	VIOLATION OF THIS SE CTION OR IS FOUND TO HAVE REPEATED LY VIOLATED THIS 19
253	253	SECTION, THE PHYSICIAN IS SUB JECT TO EXCLUSION FROM PARTI CIPATION IN THE 20
254	254	MARYLAND MEDICAL ASSISTANCE PROGRAM. 21
255	255
256	256	(M) (1) IN A CIVIL ACTION AGA INST A HOSPITAL FOR A VIOLA TION OF THIS 22
257	257	SECTION, AN INDIVIDUAL WHO INCURS PERSONAL HARM AS A D IRECT RESULT OF 23
258	258	THE VIOLATION MAY OBTAIN DAMAGES AVAIL ABLE FOR PERSONAL IN JURY AND 24
259	259	APPROPRIATE EQUITABL E RELIEF. 25
260	260
261	261	(2) IN A CIVIL ACTION AGA INST A HOSPITAL FOR A VIOLATION OF THIS 26
262	262	SECTION, A MEDICAL FACILITY THA T INCURS A FINANCIAL LOSS AS THE RESULT OF 27
263	263	THE VIOLATION MAY OBTAIN DAMAGES FOR F INANCIAL LOSS AND AP PROPRIATE 28
264	264	EQUITABLE RELIEF. 29
265	265
266	266	(3) A CIVIL ACTION AUTHORI ZED UNDER THIS PARAG RAPH SHALL BE 30
267	267	FILED WITHIN 2 YEARS AFTER THE DATE THE CAUSE O F ACTION OCCURS. 31
268	268
269	269	20–214. 32
270	270	SENATE BILL 1175 7
271	271
272	272
273	273	(b) (1) [A] EXCEPT AS PROVIDED IN § 19–342.1 OF THIS ARTICLE , A 1
274	274	licensed hospital, hospital director, or hospital governing board may not be required: 2
275	275
276	276	(i) To [permit] AUTHORIZE, within the hospital, the performance 3
277	277	of any medical procedure that results in artificial insemination, sterilization, or 4
278	278	termination of pregnancy; or 5
279	279
280	280	(ii) To refer to any source for these medical procedures. 6
281	281
282	282	(2) The refusal to [permit] AUTHORIZE or to refer to a source for these 7
283	283	procedures may not be grounds for: 8
284	284
285	285	(i) Civil liability to another person; or 9
286	286
287	287	(ii) Disciplinary or other recriminatory action against the person by 10
288	288	this State or any person. 11
289	289
290	290	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 12
291	291	October 1, 2024. 13