EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb1175*
SENATE BILL 1175
J3, J1 4lr3318
By: Senator Lam
Introduced and read first time: February 15, 2024
Assigned to: Rules
A BILL ENTITLED
AN ACT concerning 1
Hospitals – Emergency Medical Conditions – Procedures 2
(Maryland Lifesaving Treatment Access and Abortion Protection Act) 3
FOR the purpose of requiring a hospital to conduct screening on an individual presenting 4
at an emergency department of the hospital to determine whether the individual has 5
an emergency medical condition; establishing requirements and prohibitions related 6
to the treatment and transfer of an individual who has an emergency medical 7
condition; prohibiting a hospital from taking adverse action against a provider for 8
not transferring a patient who is not stabilized or against a hospital employee if the 9
employee reports a violation of this Act; and generally relating to emergency medical 10
conditions and hospitals. 11
BY adding to 12
Article – Health – General 13
Section 19–342.1 14
Annotated Code of Maryland 15
(2023 Replacement Volume) 16
BY repealing and reenacting, with amendments, 17
Article – Health – General 18
Section 20–214(b) 19
Annotated Code of Maryland 20
(2023 Replacement Volume) 21
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 22
That the Laws of Maryland read as follows: 23
Article – Health – General 24
19–342.1. 25 2 SENATE BILL 1175
(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS 1
INDICATED. 2
(2) “EMERGENCY MEDICAL CONDITION” MEANS: 3
(I) A MEDICAL CONDITION THAT PRESENTS THROUG H ACUTE 4
SYMPTOMS OF SUFFICIE NT SEVERITY, INCLUDING SEVERE PAI N, AND FOR WHICH 5
THE ABSENCE OF IMMED IATE MEDICAL ATTENTI ON COULD BE REASONAB LY 6
EXPECTED TO RESULT I N: 7
1. PLACING THE HEALTH OF THE INDIVIDUAL OR , WITH 8
RESPECT TO A PREGNAN T WOMAN, THE HEALTH OF THE WO MAN OR HER UNBORN 9
CHILD, IN SERIOUS JEOPARDY ; 10
2. SERIOUS IMPAIRMENT TO BODILY FUNCTIONS ; OR 11
3. SERIOUS DYSFUNCTION O F ANY BODILY ORGAN O R 12
BODY PART; OR 13
(II) WITH RESPECT TO A PREGNANT W OMAN WHO IS HAVING 14
CONTRACTIONS : 15
1. THERE BEING INADEQUAT E TIME TO EFFECT A S AFE 16
TRANSFER TO ANOTHER HOSPITAL BEFORE DELI VERY; OR 17
2. TRANSFER POSING A THR EAT TO THE HEALTH OR 18
SAFETY OF THE WOMAN OR UNBORN CHILD . 19
(3) “STABILIZE” MEANS: 20
(I) FOR AN EMERGENCY MEDI CAL CONDITION AS DEFINED IN 21
PARAGRAPH (2)(I) OF THIS SUBSECTION, TO PROVIDE THE MEDICAL TREATMENT 22
NECESSARY TO ENSURE, WITHIN REASONABLE ME DICAL PROBABILITY , THAT NO 23
MATERIAL DETERIORATI ON OF THE CONDITION IS LIKELY TO RESULT FRO M OR 24
OCCUR DURING THE TRA NSFER OF THE INDIVID UAL FROM THE FACILIT Y; OR 25
(II) FOR AN EMERGENCY MEDI CAL CONDITION AS DEFINED IN 26
PARAGRAPH (2)(II) OF THIS SUBSECTION, THE WOMAN HAS DELIVE RED THE 27
NEWBORN, INCLUDING DELIVERY O F THE PLACEN TA. 28
(B) THIS SECTION APPLIES ONLY TO A HOSPITAL W ITH AN EMERGENCY 29
DEPARTMENT . 30 SENATE BILL 1175 3
(C) ON THE REQUEST OF AN INDIVIDUAL PRESENTING AT A HOSP ITAL 1
EMERGENCY DEPARTMENT , OR THE INDIVIDUAL ’S REPRESENTATIVE , A HOSPITAL 2
SHALL PROVIDE AN APPROPRIA TE MEDICAL SCREENING TO DETERMINE WHETHER 3
THE INDIVIDUAL HAS A N EMERGENCY MEDICAL CONDITION. 4
(D) IF A HOSPITAL DETERMI NES THAT AN INDIVIDU AL HAS AN EMERGENCY 5
MEDICAL CONDITION , THE HOSPITAL SHALL : 6
(1) USING THE STAFF AND FACILI TIES AVAILABLE AT THE H OSPITAL, 7
PROVIDE FURTHER EXAM INATION AND THE TREATMENT REQUIRED T O STABILIZE 8
THE EMERGENCY MEDICA L CONDITION; OR 9
(2) TRANSFER THE INDIVIDU AL TO ANOTHER MEDICA L FACILITY. 10
(E) (1) A HOSPITAL IS CONSIDER ED TO HAVE MET THE R EQUIREMENTS 11
OF THIS SECTION IF, AFTER OFFERING FURTH ER EXAMINATION AND T REATMENT OR 12
TRANSFER TO THE INDI VIDUAL OR THE INDIVI DUAL’S REPRESENTATIVE , AND 13
INFORMING THE INDIVI DUAL OR INDIVIDUAL ’S REPRESENTATIVE OF THE RISKS AND 14
BENEFITS OF FURTHER EXAMINATION AND TREA TMENT OR TRANSFER : 15
(I) AN INDIVIDUAL OR THE INDIVIDUAL’S REPRESENTATIVE 16
REFUSES TO CONSENT T O FURTHER EXAMINATIO N AND TREATMENT ; OR 17
(II) AN INDIVIDUAL OR THE INDIVIDUAL’S REPRESENTATIVE 18
REFUSES TO CONSENT T O A TRANSFER TO ANOT HER MEDICAL FACILITY . 19
(2) A HOSPITAL SHALL TAKE REASONABLE STEPS TO SECURE 20
WRITTEN INFORMED CON SENT TO THE REFUSAL OF AN EXAMINATION OR 21
TREATMENT OR TRANSFER UNDER THIS SUBSECTIO N FROM THE INDIVIDUAL OR 22
THE INDIVIDUAL ’S REPRESENTATIVE . 23
(F) IF AN INDIVIDUAL HAS AN EMERGENCY MEDICAL CONDITION TH AT HAS 24
NOT BEEN STABILIZED , THE HOSPITAL MAY NOT TRANSFER THE INDIVID UAL 25
UNLESS: 26
(1) THE TRAN SFERRING HOSPITAL PR OVIDES THE MEDICAL 27
TREATMENT AVAILABLE AT THE HOS PITAL THAT MINIMIZES THE RISKS TO THE 28
INDIVIDUAL’S HEALTH AND , IN THE CASE OF A WOM AN IN LABOR, THE HEALTH OF 29
THE UNBORN CHILD ; 30
(2) THE RECEIVING FACILIT Y HAS AVAILABLE SPACE AND QUALIFIED 31
PERSONNEL TO TREAT THE INDIVIDUAL AND HAS AGREED TO ACCEPT THE 32 4 SENATE BILL 1175
TRANSFER O F THE INDIVIDUAL AND TO PROV IDE APPROPRIATE MEDIC AL 1
TREATMENT ; 2
(3) THE TRANSFERRING HOSP ITAL PROVIDES TO THE RECEIVING 3
FACILITY ALL MEDICAL RECORDS OR COPIES OF MEDICAL RECORDS RELATING TO: 4
(I) THE INDIVIDUAL’S EMERGENCY MEDICAL CONDITION; 5
(II) OBSERVATION OF SIGNS AND SYMPTOMS ; 6
(III) PRELIMINARY DIAGNOSIS ; 7
(IV) TREATMENT PROVIDED ; 8
(V) TEST RESULTS; 9
(VI) THE INFORMED WRITTEN CONSENT AND CERTIFIC ATION 10
REQUIRED UNDER ITEM (5) OF THIS PARAGRAPH ; AND 11
(VII) THE NAME AND ADDRESS OF ANY ON–CALL PHYSICIAN WHO 12
HAS REFUSED OR FAILE D TO APPEAR WITHIN A REASONABLE TIME TO P ROVIDE 13
NECESSARY STABILIZIN G TREATMENT ; 14
(4) THE TRANSFER IS EFFEC TED THROUGH QUALIFIE D PERSONNEL 15
AND TRANSPORTATION E QUIPMENT, INCLUDING THE U SE OF NECESSARY AND 16
MEDICALLY APPROPRIAT E LIFE SUPPORT MEASU RES DURING THE TRANS FER; AND 17
(5) (I) THE INDIVIDUAL OR THE INDIVIDUAL’S REPRESENTATIVE , 18
AFTER BEING INFORMED OF THE HOSPITAL ’S RESPONSIBILITIES UNDER THIS 19
SECTION AND THE RISK S OF TRANSFER , REQUESTS IN WRITING THE TRANSFER TO 20
ANOTHER FACILITY ; AND 21
(II) 1. A PHYSICIAN HAS SIGNED A CERTIFICATION THAT : 22
A. STATES THAT BASED ON THE INFORMATION 23
AVAILABLE AT THE TIM E OF TRANSFER , THE MEDICAL BE NEFITS REASONABLY 24
EXPECTED FROM THE PR OVISION OF APPROPRIA TE MEDICAL TREATMENT AT 25
ANOTHER MEDICAL FACI LITY OUTWEIGH THE RI SKS TO THE INDIVIDUA L AND, IN 26
THE CASE OF LABOR , TO THE UNBORN CHILD FROM EFFECTING THE T RANSFER; AND 27
B. CONTAINS A SUMMARY OF THE RISKS AND BENEFITS 28
OF TRANSFER; OR 29
SENATE BILL 1175 5
2. IF A PHYSICIAN IS NOT PHYSICALLY PRESENT I N THE 1
EMERGENCY DEPARTMENT AT THE TIME THE INDI VIDUAL IS TRANSFERRE D, A 2
QUALIFIED MEDICAL PR OVIDER HAS SIGNED A CERTIFICATION THAT : 3
A. STATES THAT BASED ON THE INFO RMATION 4
AVAILABLE AT THE TIM E OF TRANSFER , THE MEDICAL BENEFITS REASONABLY 5
EXPECTED FROM THE PR OVISION OF APPROPRIA TE MEDICAL TREATMENT AT 6
ANOTHER MEDICAL FACI LITY OUTWEIGH THE RI SKS TO THE INDIVIDUA L AND, IN 7
THE CASE OF LABOR , TO THE UNBORN CHILD FROM EFFECTING THE TRANSFER ; 8
B. CONTAINS A SUMMARY OF THE RISKS AND BENEFI TS 9
OF TRANSFER; AND 10
C. IS SUBSEQUENTLY COUNT ERSIGNED BY A PHYSIC IAN 11
WHO, IN CONSULTATION WITH THE QUALIFIED MEDICA L PROVIDER, HAS MADE THE 12
DETERMINATION THAT B ASED ON THE INFORMAT ION AVAILABLE AT THE TIME OF 13
TRANSFER, THE MEDICAL BENEFITS REASONABLY EXPECTED FROM THE PROVISION 14
OF APPROPRIATE MEDIC AL TREATMENT AT ANOT HER MEDICAL FACILITY 15
OUTWEIGHED THE RISKS TO THE INDIVIDUAL AN D, IN THE CASE OF LABOR , TO THE 16
UNBORN CHILD FROM EF FECTING THE TRANSFER . 17
(G) IF A PHYSICIAN DETERM INES AFTER THE MEDICAL SCREENIN G THAT AN 18
INDIVIDUAL REQUIRES THE SERVICES OF A PH YSICIAN ON THE HOSPI TAL’S LIST OF 19
ON–CALL PHYSICIANS , AND THE ON–CALL PHYSICIAN REFUS ES OR FAILS TO APPEA R 20
WITHIN A REASONABLE PERIOD OF TIME AFTER NOTIFICATION FROM TH E 21
PHYSICIAN, THE PHYSICIAN WHO PROVIDED NOTIFICATION TO THE ON–CALL 22
PHYSICIAN IS NOT LIABLE FOR A PENALTY UNDER THIS S ECTION FOR A TRANSFE R 23
THAT OTHERWISE MET T HE REQUIREMENTS OF S UBSECTION (F) OF THIS SECTION. 24
(H) A HOSPITAL THAT HAS SP ECIALIZED CAPABILITI ES OR FACILITIES OR A 25
REGIONAL REFE RRAL CENTER MAY NOT REFUSE AN APPROPRIAT E TRANSFER OF AN 26
INDIVIDUAL WHO REQUI RES THE HOSPITAL ’S SPECIALIZED CAPABILI TIES OR 27
FACILITIES IF THE HO SPITAL HAS THE CAPAC ITY TO TREAT THE IND IVIDUAL. 28
(I) A HOSPITAL MAY NOT DEL AY PROVIDING AN APPROPRIATE MEDIC AL 29
SCREENING EXAMINATIO N OR FURTHER MEDICAL EXAMINATION TO INQUI RE ABOUT 30
THE INDIVIDUAL ’S METHOD OF PAYMENT OR INSURANCE STATUS . 31
(J) A HOSPITAL MAY NOT PENALIZE OR TAKE OTHER ADVERSE ACTION 32
AGAINST: 33
6 SENATE BILL 1175
(1) A QUALIFIED MEDICAL PROVIDER IF THE PROVIDER REFUSES TO 1
AUTHORIZE THE TRANSF ER OF AN INDIVIDUAL WITH AN EMERGENCY ME DICAL 2
CONDITION THAT HAS N OT BEEN STABILIZED ; OR 3
(2) A HOSPITAL EMPLOYEE IF THE EMPLOYEE REPORTS A VIOLATION 4
OF THIS SECTION. 5
(K) A HOSPITAL THAT NEGLIG ENTLY VIOLATES THIS SE CTION IS SUBJECT 6
TO A CIVIL PENALTY O F: 7
(1) FOR A HOSPITAL WITH 100 OR MORE BEDS , NOT MORE THAN 8
$50,000 FOR EACH VIOLATION; OR 9
(2) FOR A HOSPITAL WITH F EWER THAN 100 BEDS, NOT MORE THAN 10
$25,000 FOR EACH VIOLATION. 11
(L) (1) A PHYSICIAN, INCLUDING AN ON –CALL PHYSICIAN , WHO IS 12
RESPONSIBLE FOR THE EXAMINATION , TREATMENT , OR TRANSFER OF AN 13
INDIVIDUAL UNDER THI S SECTION AND WHO NE GLIGENTLY VIOLATES T HIS SECTION 14
IS SUBJECT TO A CIVIL PENALTY OF NOT MOR E THAN $50,000 FOR EACH VIOLATIO N. 15
(2) IF A PHYSICIAN, INCLUDING AN ON –CALL PHYSICIAN , WHO IS 16
RESPONSIBLE FOR THE EXAMINATION , TREATMENT , OR TRANSFER OF AN 17
INDIVIDUAL UNDER THI S SECTION IS FOUND T O BE GROSSLY NEGLIGENT IN A 18
VIOLATION OF THIS SE CTION OR IS FOUND TO HAVE REPEATED LY VIOLATED THIS 19
SECTION, THE PHYSICIAN IS SUB JECT TO EXCLUSION FROM PARTI CIPATION IN THE 20
MARYLAND MEDICAL ASSISTANCE PROGRAM. 21
(M) (1) IN A CIVIL ACTION AGA INST A HOSPITAL FOR A VIOLA TION OF THIS 22
SECTION, AN INDIVIDUAL WHO INCURS PERSONAL HARM AS A D IRECT RESULT OF 23
THE VIOLATION MAY OBTAIN DAMAGES AVAIL ABLE FOR PERSONAL IN JURY AND 24
APPROPRIATE EQUITABL E RELIEF. 25
(2) IN A CIVIL ACTION AGA INST A HOSPITAL FOR A VIOLATION OF THIS 26
SECTION, A MEDICAL FACILITY THA T INCURS A FINANCIAL LOSS AS THE RESULT OF 27
THE VIOLATION MAY OBTAIN DAMAGES FOR F INANCIAL LOSS AND AP PROPRIATE 28
EQUITABLE RELIEF. 29
(3) A CIVIL ACTION AUTHORI ZED UNDER THIS PARAG RAPH SHALL BE 30
FILED WITHIN 2 YEARS AFTER THE DATE THE CAUSE O F ACTION OCCURS. 31
20–214. 32
SENATE BILL 1175 7
(b) (1) [A] EXCEPT AS PROVIDED IN § 19–342.1 OF THIS ARTICLE , A 1
licensed hospital, hospital director, or hospital governing board may not be required: 2
(i) To [permit] AUTHORIZE, within the hospital, the performance 3
of any medical procedure that results in artificial insemination, sterilization, or 4
termination of pregnancy; or 5
(ii) To refer to any source for these medical procedures. 6
(2) The refusal to [permit] AUTHORIZE or to refer to a source for these 7
procedures may not be grounds for: 8
(i) Civil liability to another person; or 9
(ii) Disciplinary or other recriminatory action against the person by 10
this State or any person. 11
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 12
October 1, 2024. 13