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.
*sb0614*
SENATE BILL 614
I3, J3 5lr2316
CF HB 1020
By: Senator Lam
Introduced and read first time: January 24, 2025
Assigned to: Finance
Committee Report: Favorable with amendments
Senate action: Adopted
Read second time: March 18, 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) and (4) 19
Annotated Code of Maryland 20
(2023 Replacement Volume and 2024 Supplement) 21
BY repealing and reenacting, with amendments, 22 2 SENATE BILL 614
Article – Health – General 1
Section 19–214.2(f) 19–214.2(b) 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
SENATE BILL 614 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 CLOSED –END CREDIT PLAN OFFERED SPECIFICALLY 3
SOLELY FOR THE PAYMENT OF HEALTH CA RE SERVICES, PRODUCTS, DEVICES, 4
DURABLE MEDICAL EQUI PMENT, OR PRESCRIPTION DRUGS . 5
(B) (1) A CONSUMER REPORTING A GENCY MAY NOT INCLUDE IN A 6
CONSUMER REPORT A CONSUMER ’S PAID MEDICAL DEBT OR A MEDICAL DEBT OF 7
LESS THAN $500 REGARDLESS OF THE DATE THE MEDI CAL DEBT WAS INCURRE D: 8
(I) MAKE, CREATE, OR FURNISH ANY CONSU MER REPORT 9
CONTAINING, INCORPORATING , OR REFLECTING : 10
1. ANY ADVERSE INFORMATI ON THAT THE CONSUMER 11
REPORTING AGENCY KNO WS OR SHOULD KNOW RE LATES TO MEDICAL DEB T 12
INCURRED BY THE CONSUMER ; OR 13
2. ANY COLLECTION ACTION AGAINST A CONSUMER T O 14
COLLECT MEDICAL DEBT ; OR 15
(II) MAINTAIN IN A FILE ON A CONSUMER ANY INFOR MATION 16
RELATING TO: 17
1. MEDICAL DEBT INCURRED BY THE CONSUMER ; OR 18
2. ANY COLLECTION ACTION AGAINST THE CONSUMER 19
TO COLLECT MEDICAL D EBT. 20
(2) THE PROHIBITIONS ESTA BLISHED UNDER PARAGR APH (1) OF 21
THIS SUBSECTION APPL Y REGARDLESS OF WHEN MEDICAL DEBT WAS INC URRED BY 22
A CONSUMER . 23
(C) A PERSON MAY NOT USE M EDICAL DEBT INFORMAT ION INCLUDED IN A 24
CONSUMER REPORT TO M AKE A DETERMINATION REGARDING THE 25
CREDITWORTHINESS OF THE CONSUMER . 26
Article – Health – General 27
19–214.2. 28
(a) (1) Each hospital annually shall submit to the Commission: 29
(i) At times prescribed by the Commission, the hospital’s policy on 30
the collection of debts owed by patients; and 31
4 SENATE BILL 614
(ii) A report including: 1
1. The total number of patients by race or ethnicity, gender, 2
and zip code of residence against whom the hospital, or a debt collector used by the hospital, 3
filed an action to collect a debt owed on a hospital bill; 4
2. The total number of patients by race or ethnicity, gender, 5
and zip code of residence with respect to whom the hospital has and has not reported or 6
classified a bad debt; and 7
3. The total dollar amount of the charges for hospital services 8
provided to patients but not collected by the hospital for patients covered by insurance, 9
including the out–of–pocket costs for patients covered by insurance, and patients without 10
insurance. 11
(b) The policy submitted under subsection (a)(1) of this section shall: 12
(1) Provide for active oversight by the hospital of any contract for collection 13
of debts on behalf of the hospital; 14
(2) Prohibit the hospital from selling any debt; 15
(3) Prohibit the charging of interest on bills incurred by self–pay patients 16
before a court judgment is obtained; 17
(4) Describe in detail the consideration by the hospital of patient income, 18
assets, and other criteria; 19
(5) Prohibit the hospital from [reporting]: 20
(I) REPORTING ADVERSE INFORMATION to a consumer reporting 21
agency; or [filing] 22
(II) FILING a civil action to collect a debt within 180 days after the 23
initial bill is provided; 24
(6) Describe the hospital’s procedures for collecting a debt; 25
(7) Describe the circumstances in which the hospital will seek a judgment 26
against a patient; 27
(8) In accordance with subsection (c) of this section, provide for a refund of 28
amounts collected from a patient or the guarantor of a patient who was later found to be 29
eligible for free care within 240 days after the initial bill was provided; 30
(9) If the hospital has obtained a judgment against or reported adverse 31
information to a consumer reporting agency about a patient who later was found to be 32 SENATE BILL 614 5
eligible for free care within 240 days after the initial bill was provided for which the 1
judgment was awarded or the adverse information was reported, require the hospital to 2
seek to vacate the judgment or strike the adverse information; 3
(10) Provide a mechanism for a patient to: 4
(i) Request the hospital to reconsider the denial of free or 5
reduced–cost care; 6
(ii) File with the hospital a complaint against the hospital or a debt 7
collector used by the hospital regarding the handling of the patient’s bill; and 8
(iii) Allow the patient and the hospital to mutually agree to modify 9
the terms of a payment plan offered under subsection (e) of this section or entered into with 10
the patient; [and] 11
(11) Prohibit the hospital from collecting additional fees in an amount that 12
exceeds the approved charge for the hospital service as established by the Commission for 13
which the medical debt is owed on a bill for a patient who is eligible for free or 14
reduced–cost care under the hospital’s financial assistance policy; AND 15
(12) COMPLY WITH § 24–2502 OF THIS ARTICLE . 16
(e) (1) Subject to paragraph (2) of this subsection, a hospital shall provide in 17
writing to each patient who incurs medical debt information about the availability of an 18
installment payment plan for the debt. 19
(4) (i) A patient shall be deemed to be compliant with a payment plan 20
if the patient makes at least 11 scheduled monthly payments within a 12–month period. 21
(ii) If a patient misses a scheduled monthly payment, the patient 22
shall contact the health care facility and identify a plan to make up the missed payment 23
within 1 year after the date of the missed payment. 24
(iii) The health care facility may, but may not be required to, waive 25
any additional missed payments that occur within a 12–month period and allow the patient 26
to continue to participate in the income–based payment plan and not refer the outstanding 27
balance owed to a collection agency or for legal action. 28
(f) (1) A HOSPITAL SHALL COMPLY WITH § 24–2502 OF THIS ARTICLE. 29
(2) For at least 180 days after issuing an initial patient bill, a hospital may 30
not report adverse information about a patient to a consumer reporting agency or 31
commence civil action against a patient for nonpayment. 32
6 SENATE BILL 614
[(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 T HE MEANINGS 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, GOVERNM ENT OR 32
GOVERNMENT SUBDIVISI ON, AGENCY, OR OTHER ENTITY THAT PURCHASES 33
MEDICAL DEBT OR COLL ECTS MEDICAL DEBT ON BEHALF OF ANOTHER . 34 SENATE BILL 614 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 PROVIDIN G 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 FOR THE PURCH ASE OR COLLECTION OF MEDICAL DEBT 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 UNDER SUBSEC TION (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.
________________________________________________________________________________
President of the Senate.
________________________________________________________________________________
Speaker of the House of Delegates.