Procurement Contracts and Construction Contracts - Payments
Summary
HB1336 revises Maryland’s hospital free-care refund process for patients who paid out-of-pocket hospital charges but should have qualified for free care. It directs the Department of Human Services and the Health Services Cost Review Commission to use hospital-provided information to identify potentially eligible patients for services received during calendar years 2017 through 2021, notify those patients, and help them seek refunds. Acute care and chronic care hospitals would be required to determine eligibility for patients who contact them and issue refunds to qualifying patients within 30 days of a request.
The bill also requires hospitals to maintain a public webpage with refund information and contact details, and to conduct a broad marketing campaign to inform patients about the availability of refunds and how to apply. It preserves the role of the Health Education and Advocacy Unit in assisting patients and requires hospitals to reimburse certain State entities for administrative costs associated with implementing the refund process. The bill authorizes the Commission to impose fines for noncompliance and treats violations as unfair, abusive, or deceptive trade practices under Maryland consumer law.
Impact
HB1336 amends Maryland Health – General § 19-214.4 and extends and modifies the hospital medical bill reimbursement framework created by Chapter 683 of the Acts of 2022. It changes the process from a State-driven identification and reimbursement model to one in which DHS notifies potentially eligible patients and hospitals determine eligibility and issue refunds, while also clarifying that patients previously denied free care because of a failed asset test are not entitled to a refund. The bill also changes the implementation timeline, requiring hospitals to begin receiving refund requests and issuing refunds by January 1, 2025, and extends the underlying 2022 act’s sunset date from June 30, 2025 to June 30, 2028.
Sentiment
Based on the bill text and available context, the measure appears to be framed as a consumer-protection and patient-relief bill, with an emphasis on ensuring that low-income patients who were eligible for free care are made whole. The absence of recorded votes or committee testimony in the provided materials limits insight into formal support or opposition, but the structure of the bill suggests a policy goal of expanding access to refunds and improving outreach to affected patients. The inclusion of enforcement mechanisms and mandatory marketing indicates an intent to make the refund process more effective and visible.
Contention
The main points of contention likely involve administrative burden, data-sharing, and the scope of eligibility. Hospitals are required to identify eligibility, provide refunds, run marketing campaigns, and reimburse State agencies for implementation costs, which may raise concerns about compliance costs and operational complexity. Another likely issue is the bill’s reliance on historical eligibility standards from 2017 through 2021 and its exclusion of patients previously denied free care due to a failed asset test, which narrows who can receive refunds. The bill also requires sensitive information sharing among State entities and hospitals, making confidentiality and data-use safeguards another potential area of concern.