Medical Debt Protections Maryland
A Guide to your Rights
This guide is designed to walk you through different options and rights you have to receive affordable hospital health care at different stages in the process which are specific to Maryland.
Paying for Hospital Care - Financial Assistance
You may be eligible for free or reduced-cost care. By law, Maryland’s nonprofit hospitals must offer free and low-cost care for eligible patients
Eligibility requirements for free or reduced-cost care varies by hospital but is based on income using federal poverty guidelines (FPL) to determine eligibility
How do I find hospital assistance policies? We have listed some below but if your hospital isn’t listed, google “hospital name financial assistance policies” and that should take you to the right link. Below are links for some of the larger hospital systems in Maryland. Click on the hospital system to see the eligibility requirements and access the financial assistance policy/application.
To complete the financial application, you will need your federal income tax return and other proof of income including financial documents such as pay stubs or proof of unemployment.
You may not need to fill out the financial assistance form if you can show that you receive other state support. If you can prove you receive one or more of the following benefits, you can show your enrollment in the program with a financial assistance application instead of income tax and other financial records:
Supplemental Nutritional Assistance Program (SNAP)
Women, infants and children (WIC)
Low-income household energy assistance
Households with children in free or reduced-cost meals program
Other state assistance programs (see hospital for list of programs).
What Hospitals CANNOT Do
Hospitals cannot ask about your citizenship or immigration status as part of the financial assistance process
Hospitals cannot charge interest or fees on your medical bill if you qualify for free or reduced cost care
What Happens if You are Denied Free or Reduced-Cost Care?
If you are approved for financial assistance, great. If you are denied financial assistance but believe you should have qualified for help, you can appeal the decision. You can contact the Maryland Attorney General’s Health Advocacy Unit at: Health Advocacy Unit (Tel) 410-528-1840 or website.
You can also file a complaint with the Maryland Health Services Cost Review Commission (HSCRC) if you believe there was a violation of the financial assistance policy at hscrc.patient-complaints@maryland.gov.
Tips for applying for hospital care. Here is some more general information and tips on applying for hospital financial assistance from: Dollar For - a nonprofit in Oregon produced this TikTok & Twitter thread
If You Receive a Hospital Bill You Cannot Pay?
If your financial circumstances have changed and you believe you now would qualify for free or reduced cost care, you have 240 days after you receive your initial bill to apply
You can call the hospital and ask to negotiate a payment plan. As a rule of thumb, you shouldn’t agree to a monthly payment that is more than 10% of your monthly income. Advocates are currently working with hospitals to create guidance for installment payment plans of no more than 5% of gross monthly income but those plans won’t be in place until Spring 2022. In the meantime, call and ask for a payment plan!
You can ask for an itemized bill of all of your charges. You can then question some charges that seem high or unnecessary
What Hospitals CAN do to collect a Debt
The Consumer Financial Protection Bureau (CFPB) has new rules on debt collection starting November 30, 2021. These new rules allow debt collectors (including hospitals) to:
Call you 7 times per week per debt
Use email and social media to try to collect the debt unless you opt-out
After 180 days, the hospital can report the debt to a consumer credit agency
Hospitals must file an affidavit before starting debt collection activity stating that a ‘good faith” effort was made to create a payment plan with the patient
VS
What Hospitals CANNOT do to collect a Debt
Until Maryland hospitals and advocates agree on an income-based installment payment plan and hospitals are able to implement the plan, hospitals cannot pursue medical debt for collection or file a lawsuit. This applies to all Maryland hospital debts from June 2021 onward but not to bills sent before June 2021. This moratorium is likely to last until Spring 2022
Hospitals cannot report adverse information to a consumer credit agency if you were eligible for free or reduced cost care or if an appeal is underway
Hospitals cannot place a lien on your home for medical debt
Hospitals cannot arrest or jail you for owing medical debt
Hospitals cannot garnish your wages if you are eligible for free or reduced cost care
The Medical Bill Reimbursement Act of 2022
A new law comes into effect on July 1st of 2022 that will require hospitals to pay certain patients back for medical debt that was wrongfully collected. A report conducted by the Maryland Hospital Services Cost Review Commission (HSCRC) found that low-income patients paid Maryland hospitals $120 million in 2017-2018 on top of the money hospitals received from the state to provide these same patients with free or reduced cost care. The law instructs Maryland hospitals, the Comptroller, and state agencies to develop a process to identify and reimburse patients* from 2017-2021 that qualified for free hospital care but were wrongfully charged and pursued by debt collectors. The hospitals will have until January 2023 to design and implement the process. This is the first law of its kind in the country and an estimated $200 million is expected to be returned to low-income patients.
*The reimbursement process is automatic and requires no further action on the part of the patient.
Medical Debt Freedom Fund
If you have a hospital debt you cannot pay, you can apply to our Medical Debt Freedom Fund for assistance. Our Freedom Fund may be able to help you pay your debt.
For more information or assistance contact us at 410-220-0494 or info@marylandconsumers.org