EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb1020*
HOUSE BILL 1020
I3, J3 5lr2315
CF SB 614
By: Delegate Palakovich Carr
Introduced and read first time: February 3, 2025
Assigned to: Economic Matters
Committee Report: Favorable with amendments
House action: Adopted
Read second time: February 25, 2025
CHAPTER ______
AN ACT concerning 1
Consumer Protection – Credit Reporting – Medical Debt 2
(Fair Medical Debt Reporting Act) 3
FOR the purpose of prohibiting a consumer reporting agency from including certain 4
medical debt information in a consumer report; prohibiting a person from using 5
medical debt information included in a consumer report when making a 6
creditworthiness determination; prohibiting certain entities from disclosing medical 7
debt to a consumer reporting agency; requiring certain entities to include a certain 8
provision in contracts entered into with a collection entity regarding medical debt 9
and establishing a contract that does not contain the provision is void and 10
unenforceable; and generally relating to credit reporting and medical debt. 11
BY adding to 12
Article – Commercial Law 13
Section 14–1213 14
Annotated Code of Maryland 15
(2013 Replacement Volume and 2024 Supplement) 16
BY repealing and reenacting, without amendments, 17
Article – Health – General 18
Section 19–214.2(a)(1) and (e)(1) 19
Annotated Code of Maryland 20
(2023 Replacement Volume and 2024 Supplement) 21
BY repealing and reenacting, with amendments, 22 2 HOUSE BILL 1020
Article – Health – General 1
Section 19–214.2(f) 19–214.2(b), (e)(4), and (f) 2
Annotated Code of Maryland 3
(2023 Replacement Volume and 2024 Supplement) 4
BY adding to 5
Article – Health – General 6
Section 24–2501 and 24–2502 be under the new subtitle “Subtitle 25. Medical Debt 7
Reporting” 8
Annotated Code of Maryland 9
(2023 Replacement Volume and 2024 Supplement) 10
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 11
That the Laws of Maryland read as follows: 12
Article – Commercial Law 13
14–1213. 14
(A) (1) IN THIS SECTION, “MEDICAL DEBT ” MEANS AN OBLIGATION OF A 15
CONSUMER TO PAY ANY AMOUNT RELATED TO TH E RECEIPT OF HEALTH CARE 16
SERVICES, PRODUCTS, DEVICES, DURABLE MEDICAL EQUI PMENT, OR 17
PRESCRIPTION DRUGS P ROVIDED TO A PERSON BY: 18
(I) A HEALTH CARE FACILITY AS DEFINED IN § 19–114 OF THE 19
HEALTH – GENERAL ARTICLE; 20
(II) A HEALTH CARE PRACTITI ONER AS DEFINED IN § 19–114 OF 21
THE HEALTH – GENERAL ARTICLE; OR 22
(III) AN AMBULANCE SERVICE AS DEFINED IN § 13–515 OF THE 23
EDUCATION ARTICLE DEBT OWED BY A CONSU MER TO: 24
(I) A PERSON WHOSE PRIMARY BUSINESS IS PROVIDIN G 25
MEDICAL SERVICES , PRODUCTS, OR DEVICES; OR 26
(II) THE PERSON’S AGENT OR ASSIGNEE FOR THE PROVISION OF 27
MEDICAL SERVICES , PRODUCTS, OR DEVICES. 28
(2) “MEDICAL DEBT” INCLUDES MEDICAL BIL LS THAT: 29
(I) ARE NOT PAST DUE ; OR 30
(II) HAVE ALREADY BEEN PAI D. 31
HOUSE BILL 1020 3
(3) “MEDICAL DEBT ” DOES NOT INCLUDE DEB T CHARGED TO A 1
CREDIT CARD UNLESS T HE CREDIT CARD IS IS SUED UNDER AN OPEN–ENDED OR A 2
CLOSE–ENDED OPEN–END OR CLOSE –END CRED IT PLAN OFFERED SPECIFI CALLY 3
FOR THE PAYMENT OF H EALTH CARE SERVICES , PRODUCTS, OR DEVICES, DURABLE 4
MEDICAL EQUIPMENT , OR PRESCRIPTION DRUGS . 5
(B) (1) A CONSUMER REPORTING A GENCY MAY NOT : 6
(I) MAKE, CREATE, OR FURNISH ANY CONSU MER REPORT 7
CONTAINING, INCORPORATING , OR REFLECTING : 8
1. ANY ADVERSE INFORMATI ON THAT THE CONSUMER 9
REPORTING AGENCY KNO WS OR SHOULD KNOW RE LATES TO MEDICAL DEB T 10
INCURRED BY THE CONS UMER; OR 11
2. ANY COLLECTION ACT ION AGAINST A CONSUM ER TO 12
COLLECT MEDICAL DEBT ; OR 13
(II) MAINTAIN IN A FILE ON A CONSUMER ANY INFOR MATION 14
RELATING TO: 15
1. MEDICAL DEBT INCURRED BY THE CONSUMER ; OR 16
2. ANY COLLECTION ACTION AGAINST THE CONSUMER 17
TO COLLECT MEDICAL D EBT. 18
(2) THE PROHIBITIONS ESTA BLISHED UNDER PARAGR APH (1) OF 19
THIS SUBSECTION APPL Y REGARDLESS OF WHEN MEDICAL DEBT WAS INC URRED BY 20
A CONSUMER . 21
(C) A PERSON MAY NOT USE M EDICAL DEBT INFORMAT ION INCLUDED IN A 22
CONSUMER REPORT TO M AKE A DETERMINATION REGARDING THE 23
CREDITWORTHINESS OF TH E CONSUMER . 24
Article – Health – General 25
19–214.2. 26
(a) (1) Each hospital annually shall submit to the Commission: 27
(i) At times prescribed by the Commission, the hospital’s policy on 28
the collection of debts owed by patients; and 29
(ii) A report including: 30
4 HOUSE BILL 1020
1. The total number of patients by race or ethnicity, gender, 1
and zip code of residence against whom the hospital, or a debt collector used by the hospital, 2
filed an action to collect a debt owed on a hospital bill; 3
2. The total number of patients by race or ethnicity, gender, 4
and zip code of residence with respect to whom the hospital has and has not reported or 5
classified a bad debt; and 6
3. The total dollar amount of the charges for hospital services 7
provided to patients but not collected by the hospital for patients covered by insurance, 8
including the out–of–pocket costs for patients covered by insurance, and patients without 9
insurance. 10
(b) The policy submitted under subsection (a)(1) of this section shall: 11
(1) Provide for active oversight by the hospital of any contract for collection 12
of debts on behalf of the hospital; 13
(2) Prohibit the hospital from selling any debt; 14
(3) Prohibit the charging of interest on bills incurred by self–pay patients 15
before a court judgment is obtained; 16
(4) Describe in detail the consideration by the hospital of patient income, 17
assets, and other criteria; 18
(5) Prohibit the hospital from [reporting]: 19
(I) REPORTING ADVERSE INFORMATION to a consumer reporting 20
agency; or [filing] 21
(II) FILING a civil action to collect a debt within 180 days after the 22
initial bill is provided; 23
(6) Describe the hospital’s procedures for collecting a debt; 24
(7) Describe the circumstances in which the hospital will seek a judgment 25
against a patient; 26
(8) In accordance with subsection (c) of this section, provide for a refund of 27
amounts collected from a patient or the guarantor of a patient who was later found to be 28
eligible for free care within 240 days after the initial bill was provided; 29
(9) If the hospital has obtained a judgment against or reported adverse 30
information to a consumer reporting agency about a patient who later was found to be 31
eligible for free care within 240 days after the initial bill was provided for which the 32 HOUSE BILL 1020 5
judgment was awarded or the adverse information was reported, require the hospital to 1
seek to vacate the judgment or strike the adverse information; 2
(10) Provide a mechanism for a patient to: 3
(i) Request the hospital to reconsider the denial of free or 4
reduced–cost care; 5
(ii) File with the hospital a complaint against the hospital or a debt 6
collector used by the hospital regarding the handling of the patient’s bill; and 7
(iii) Allow the patient and the hospital to mutually agree to modify 8
the terms of a payment plan offered under subsection (e) of this section or entered into with 9
the patient; [and] 10
(11) Prohibit the hospital from collecting additional fees in an amount that 11
exceeds the approved charge for the hospital service as established by the Commission for 12
which the medical debt is owed on a bill for a patient who is eligible for free or 13
reduced–cost care under the hospital’s financial assistance policy; AND 14
(12) COMPLY WITH § 24–2505 OF THIS ARTICLE . 15
(e) (1) Subject to paragraph (2) of this subsection, a hospital shall provide in 16
writing to each patient who incurs medical debt information about the availability of an 17
installment payment plan for the debt. 18
(4) (i) A patient shall be deemed to be compliant with a payment plan 19
if the patient makes at least 11 scheduled monthly payments within a 12–month period. 20
(ii) If a patient misses a scheduled monthly payment, the patient 21
shall contact the health care facility and identify a plan to make up the missed payment 22
within 1 year after the date of the missed payment. 23
(iii) The health care facility may, but may not be required to, waive 24
any additional missed payments that occur within a 12–month period and allow the patient 25
to continue to participate in the income–based payment plan and not refer the outstanding 26
balance owed [to a collection agency or] for legal action. 27
(f) (1) A HOSPITAL SHALL COMPL Y WITH § 24–2502 OF THIS ARTICLE. 28
(2) For at least 180 days after issuing an initial patient bill, a hospital may 29
not report adverse information about a patient to a consumer reporting agency or 30
commence civil action against a patient for nonpayment. 31
6 HOUSE BILL 1020
[(2)] (3) A hospital shall report the fulfillment of a patient’s payment 1
obligation within 60 days after the obligation is fulfilled to any consumer reporting agency 2
to which the hospital had reported adverse information about the patient. 3
[(3)] (4) A hospital may not report adverse information to a consumer 4
reporting agency regarding a patient who at the time of service was uninsured or eligible 5
for free or reduced–cost care under § 19–214.1 of this subtitle. 6
[(4)] (5) A hospital may not report adverse information about a patient to 7
a consumer reporting agency, commence a civil action against a patient for nonpayment, or 8
delegate collection activity to a debt collector: 9
(i) If the hospital was notified in accordance with federal law by the 10
patient or the insurance carrier that an appeal or a review of a health insurance decision 11
is pending within the immediately preceding 60 days; or 12
(ii) If the hospital has completed a requested reconsideration of the 13
denial of free or reduced–cost care that was appropriately completed by the patient within 14
the immediately preceding 60 days. 15
[(5)] (6) If a hospital has BY NOVEMBER 1, 2025, A HOSPITAL THAT 16
HAD reported adverse information about a patient to a consumer reporting agency, the 17
hospital shall instruct the consumer reporting agency to delete the adverse information 18
about the patient: 19
(i) If the hospital was informed by the patient or the insurance 20
carrier that an appeal or a review of a health insurance decision is pending, and until 60 21
days after the appeal is complete; or 22
(ii) Until 60 days after the hospital has completed a requested 23
reconsideration of the denial of free or reduced–cost care. 24
SUBTITLE 25. MEDICAL DEBT REPORTING. 25
24–2501. 26
(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANI NGS 27
INDICATED. 28
(B) “AMBULANCE SERVICE ” HAS THE MEANING STAT ED IN § 13–515 OF THE 29
EDUCATION ARTICLE. 30
(C) (B) “COLLECTION ENTITY ” MEANS ANY INDIVIDUAL , PARTNERSHIP , 31
CORPORATION , TRUST, ESTATE, COOPERATIVE , ASSOCIATION, GOVERNMENT OR 32
GOVERNMENT SUBDIVISIO N, AGENCY, OR OTHER ENTITY THAT PURCHASES 33
MEDICAL DEBT OR COLL ECTS MEDICAL DEBT ON BEHALF OF ANOTHER . 34 HOUSE BILL 1020 7
(D) “HEALTH CARE FACILITY ” HAS THE MEANING STAT ED IN § 19–114 OF 1
THIS ARTICLE. 2
(E) “HEALTH CARE PRACTITIO NER” HAS THE MEANING STATED IN § 19–114 3
OF THIS ARTICLE. 4
(F) (C) “MEDICAL DEBT” HAS THE MEANING STAT ED IN § 14–1213 OF THE 5
COMMERCIAL LAW ARTICLE. 6
24–2502. 7
(A) A HEALTH CARE FACILITY , A HEALTH CARE PRACTI TIONER, OR AN 8
AMBULANCE SERVICE A PERSON WHOSE PRIMARY BUSINESS IS PROVIDING 9
MEDICAL SERVICES , PRODUCTS, OR DEVICES , OR THE PERSON ’S AGENT OR 10
ASSIGNEE: 11
(1) MAY NOT DISCLOSE ANY PORTION OF A MEDICAL DEBT TO A 12
CONSUMER REPORTING A GENCY; AND 13
(2) SHALL INCLUDE IN ANY CONTRACT ENTERED INT O WITH A 14
COLLECTION ENTITY FO R THE PURCHASE OR COLL ECTION OF MEDICAL DE BT A 15
PROVISION PROHIBITIN G THE DISCLOSURE OF ANY PORTION OF THE M EDICAL DEBT 16
TO A CONSUMER REPORT ING AGENCY. 17
(B) A CONTRACT ENTERED INT O ON OR AFTER OCTOBER 1, 2025, THAT 18
DOES NOT INCLUDE THE PROVISION REQUIRED U NDER SUBSECTION (A)(2) OF THIS 19
SECTION IS VOID AND UNENFORCEABLE . 20
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 21
October 1, 2025. 22
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.