Maryland 2025 Regular Session

Maryland House Bill HB1324 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	hb1324
6	6
7	7	HOUSE BILL 1324
8	8	J3 5lr3381
9	9
10	10	By: Delegates Spiegel, Amprey, Fair, Kaiser, Kaufman, Lopez, Palakovich Carr,
11	11	Shetty, Solomon, Tomlinson, Wells, and Woorman
12	12	Introduced and read first time: February 7, 2025
13	13	Assigned to: Health and Government Operations
14	14
15	15	A BILL ENTITLED
16	16
17	17	AN ACT concerning 1
18	18
19	19	Hospitals – Medical Debt Collection – Sale of Patient Debt to Nonprofit 2
20	20	Organizations 3
21	21
22	22	FOR the purpose of authorizing a hospital, under certain circumstances, to sell the medical 4
23	23	debt of patients if the debt is sold to a nonprofit organization for the purpose of 5
24	24	canceling the debt; requiring that a hospital’s financial policy require the hospital to 6
25	25	dismiss actions pending against a patient for the collection of debt that was sold and 7
26	26	prohibit the hospital from engaging in specified collection activities on patient debt 8
27	27	that was sold; and generally relating to hospital debt collection policies and the sale 9
28	28	of patient debt to nonprofit organizations. 10
29	29
30	30	BY repealing and reenacting, without amendments, 11
31	31	Article – Health – General 12
32	32	Section 19–214.2(a) 13
33	33	Annotated Code of Maryland 14
34	34	(2023 Replacement Volume and 2024 Supplement) 15
35	35
36	36	BY repealing and reenacting, with amendments, 16
37	37	Article – Health – General 17
38	38	Section 19–214.2(b), (f), (m), and (n) 18
39	39	Annotated Code of Maryland 19
40	40	(2023 Replacement Volume and 2024 Supplement) 20
41	41
42	42	BY adding to 21
43	43	Article – Health – General 22
44	44	Section 19–214.2(m) 23
45	45	Annotated Code of Maryland 24
46	46	(2023 Replacement Volume and 2024 Supplement) 25
47	47	2 HOUSE BILL 1324
48	48
49	49
50	50	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 1
51	51	That the Laws of Maryland read as follows: 2
52	52
53	53	Article – Health – General 3
54	54
55	55	19–214.2. 4
56	56
57	57	(a) (1) Each hospital annually shall submit to the Commission: 5
58	58
59	59	(i) At times prescribed by the Commission, the hospital’s policy on 6
60	60	the collection of debts owed by patients; and 7
61	61
62	62	(ii) A report including: 8
63	63
64	64	1. The total number of patients by race or ethnicity, gender, 9
65	65	and zip code of residence against whom the hospital, or a debt collector used by the hospital, 10
66	66	filed an action to collect a debt owed on a hospital bill; 11
67	67
68	68	2. The total number of patients by race or ethnicity, gender, 12
69	69	and zip code of residence with respect to whom the hospital has and has not reported or 13
70	70	classified a bad debt; and 14
71	71
72	72	3. The total dollar amount of the charges for hospital services 15
73	73	provided to patients but not collected by the hospital for patients covered by insurance, 16
74	74	including the out–of–pocket costs for patients covered by insurance, and patients without 17
75	75	insurance. 18
76	76
77	77	(2) The Commission shall post the information submitted under paragraph 19
78	78	(1) of this subsection on its website. 20
79	79
80	80	(b) The policy submitted under subsection (a)(1) of this section shall: 21
81	81
82	82	(1) Provide for active oversight by the hospital of any contract for collection 22
83	83	of debts on behalf of the hospital; 23
84	84
85	85	(2) [Prohibit] EXCEPT AS PROVIDED IN SUBSECTION (M) OF THIS 24
86	86	SECTION, PROHIBIT the hospital from selling any debt; 25
87	87
88	88	(3) Prohibit the charging of interest on bills incurred by self–pay patients 26
89	89	before a court judgment is obtained; 27
90	90
91	91	(4) Describe in detail the consideration by the hospital of patient income, 28
92	92	assets, and other criteria; 29
93	93
94	94	(5) Prohibit the hospital from reporting to a consumer reporting agency or 30
95	95	filing a civil action to collect a debt within 180 days after the initial bill is provided; 31
96	96	HOUSE BILL 1324 3
97	97
98	98
99	99	(6) Describe the hospital’s procedures for collecting a debt; 1
100	100
101	101	(7) Describe the circumstances in which the hospital will seek a judgment 2
102	102	against a patient; 3
103	103
104	104	(8) In accordance with subsection (c) of this section, provide for a refund of 4
105	105	amounts collected from a patient or the guarantor of a patient who was later found to be 5
106	106	eligible for free care within 240 days after the initial bill was provided; 6
107	107
108	108	(9) If the hospital has obtained a judgment against or reported adverse 7
109	109	information to a consumer reporting agency about a patient who later was found to be 8
110	110	eligible for free care within 240 days after the initial bill was provided for which the 9
111	111	judgment was awarded or the adverse information was reported, require the hospital to 10
112	112	seek to vacate the judgment or strike the adverse information; 11
113	113
114	114	(10) Provide a mechanism for a patient to: 12
115	115
116	116	(i) Request the hospital to reconsider the denial of free or 13
117	117	reduced–cost care; 14
118	118
119	119	(ii) File with the hospital a complaint against the hospital or a debt 15
120	120	collector used by the hospital regarding the handling of the patient’s bill; and 16
121	121
122	122	(iii) Allow the patient and the hospital to mutually agree to modify 17
123	123	the terms of a payment plan offered under subsection (e) of this section or entered into with 18
124	124	the patient; [and] 19
125	125
126	126	(11) Prohibit the hospital from collecting additional fees in an amount that 20
127	127	exceeds the approved charge for the hospital service as established by the Commission for 21
128	128	which the medical debt is owed on a bill for a patient who is eligible for free or 22
129	129	reduced–cost care under the hospital’s financial assistance policy; 23
130	130
131	131	(12) REQUIRE THE HOSPITAL TO DISMISS ACTIONS P ENDING AGAINST 24
132	132	A PATIENT FOR COLLECTION OF DEBT T HAT WAS SOLD UNDER S UBSECTION (M) OF 25
133	133	THIS SECTION; AND 26
134	134
135	135	(13) PROHIBIT THE HOSPITAL FROM: 27
136	136
137	137	(I) ENGAGING IN COLLECTIO N ACTIVITIES ON 100% OF THE 28
138	138	OUTSTANDING AMOUNT O F THE COMMISSION–SET CHARGE FOR DEBT SOLD UNDER 29
139	139	SUBSECTION (M) OF THIS SECTION; AND 30
140	140
141	141	(II) COLLECTING ON JUDGMEN TS ENTERED INTO ON P ATIENT 31
142	142	DEBT THAT WAS SOLD U NDER SUBSECTION (M) OF THIS SECTION . 32
143	143	4 HOUSE BILL 1324
144	144
145	145
146	146	(f) (1) For at least 180 days after issuing an initial patient bill, a hospital may 1
147	147	not report adverse information about a patient to a consumer reporting agency or 2
148	148	commence civil action against a patient for nonpayment. 3
149	149
150	150	(2) A hospital shall report the fulfillment of a patient’s payment obligation 4
151	151	within 60 days after the obligation is fulfilled to any consumer reporting agency to which 5
152	152	the hospital had reported adverse information about the patient, INCLUDING IF THE DEB T 6
153	153	WAS SOLD UNDER SUBSE CTION (M) OF THIS SECTION . 7
154	154
155	155	(3) A hospital may not report adverse information to a consumer reporting 8
156	156	agency regarding a patient who at the time of service was uninsured or eligible for free or 9
157	157	reduced–cost care under § 19–214.1 of this subtitle. 10
158	158
159	159	(4) A hospital may not report adverse information about a patient to a 11
160	160	consumer reporting agency, commence a civil action against a patient for nonpayment, or 12
161	161	delegate collection activity to a debt collector: 13
162	162
163	163	(i) If the hospital was notified in accordance with federal law by the 14
164	164	patient or the insurance carrier that an appeal or a review of a health insurance decision 15
165	165	is pending within the immediately preceding 60 days; [or] 16
166	166
167	167	(ii) If the hospital has completed a requested reconsideration of the 17
168	168	denial of free or reduced–cost care that was appropriately completed by the patient within 18
169	169	the immediately preceding 60 days; OR 19
170	170
171	171	(III) IF THE HOSPITAL SOLD THE DEBT UNDER SUBSECTIO N (M) 20
172	172	OF THIS SECTION . 21
173	173
174	174	(5) If a hospital has reported adverse information about a patient to a 22
175	175	consumer reporting agency, the hospital shall instruct the consumer reporting agency to 23
176	176	delete the adverse information about the patient: 24
177	177
178	178	(i) If the hospital was informed by the patient or the insurance 25
179	179	carrier that an appeal or a review of a health insurance decision is pending, and until 60 26
180	180	days after the appeal is complete; or 27
181	181
182	182	(ii) Until 60 days after the hospital has completed a requested 28
183	183	reconsideration of the denial of free or reduced–cost care. 29
184	184
185	185	(M) (1) (I) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , A 30
186	186	HOSPITAL MAY SELL DE BT OWED TO THE HOSPI TAL BY A PATIENT FOR HOSPITAL 31
187	187	SERVICES TO A NONPROFIT ORGANIZATI ON THAT IS EXEMPT FRO M TAXATION 32
188	188	UNDER § 501(C)(3) OF THE INTERNAL REVENUE CODE FOR THE SOLE PURPOSE OF 33
189	189	CANCELING THE DEBT . 34
190	190	HOUSE BILL 1324 5
191	191
192	192
193	193	(II) THE CONTRACT BETWEEN THE HOSPITAL AND THE 1
194	194	NONPROFIT ORGANIZATI ON PURCHASING THE DEBT UNDER THIS SUBSECTIO N 2
195	195	SHALL: 3
196	196
197	197	1. STATE THAT THE SOLE PUR POSE OF THE SALE OF THE 4
198	198	DEBT IS TO CANCEL TH E DEBT; AND 5
199	199
200	200	2. INCLUDE A WRITTEN AGR EEMENT FROM THE 6
201	201	PATIENT ALLOWING THE DEBT TO BE SOLD . 7
202	202
203	203	(III) THE PATIENT IS NOT RE SPONSIBLE TO THE HOS PITAL OR 8
204	204	THE NONPROFIT ORGANI ZATION FOR ANY AM OUNT OF THE DEBT THA T IS SOLD 9
205	205	UNDER THIS SUBSECTIO N OR ANY INTEREST , FEES, OR COSTS ASSOCIATED WITH THE 10
206	206	DEBT OR THE SALE . 11
207	207
208	208	(2) DEBT SOLD UNDER THIS SUBSECTION MAY NOT BE SUBJECT T O 12
209	209	LEGAL RIGHTS OR CONT RACTUAL ASSIGNMENT L IMITS THAT PREVENT T HE SALE OF 13
210	210	THE DEBT, INCLUDING LIMITS DUE TO: 14
211	211
212	212	(I) CURRENT LIENS OR LEGAL PROCE SSES; 15
213	213
214	214	(II) AN EXPECTATION THAT THE DEBT WILL YIELD ADDITIONAL 16
215	215	REIMBURSEMENTS FROM A THIRD–PARTY PAYER; OR 17
216	216
217	217	(III) AN OPEN APPEAL WITH AN INSURANCE COMPANY . 18
218	218
219	219	(3) DEBT SOLD UNDER THIS SUBSECTION MAY BE SOLD WITH A 19
220	220	DISCOUNT OF COMMISSION CHARGES . 20
221	221
222	222	(4) THE COMMISSION SHALL TREA T THE AMOUNT OF PAYM ENTS TO 21
223	223	HOSPITALS UNDER THIS SUBSECTION AS AN OFF SET TO UNCOMPENSATED CARE 22
224	224	AMOUNTS REPORTED BY HOSPITALS. 23
225	225
226	226	[(m)] (N) The Commission shall review each hospital’s implementation of and 24
227	227	compliance with the hospital’s policies and the requirements of this section. 25
228	228
229	229	[(n)] (O) (1) On or before February 1 each year, beginning in 2023, the 26
230	230	Commission shall compile the information required under subsection (a) of this section and 27
231	231	prepare a medical debt collection report based on the compiled information. 28
232	232
233	233	(2) The report required under paragraph (1) of this subsection shall be: 29
234	234
235	235	(i) Made available to the public free of charge; and 30
236	236	6 HOUSE BILL 1324
237	237
238	238
239	239	(ii) Submitted to the Senate Finance Committee and the House 1
240	240	Health and Government Operations Committee in accordance with § 2–1257 of the State 2
241	241	Government Article. 3
242	242
243	243	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 4
244	244	October 1, 2025. 5
245	245