HB 268 Maryland House of Delegates · 2025 Regular Session

Hospitals - Financial Assistance and Collection of Debts - Policies

HB 268 requires Maryland hospitals to provide free medically necessary care to patients with family income at or below 200% of the federal poverty level (FPL) and reduced-cost care to patients with income between 201% and 500% FPL who experience financial hardship (defined as medical debt exceeding 25% of family income over 12 months). Specifically, for patients earning 201% to 250% FPL, hospitals must reduce out-of-pocket expenses by at least 75%. The bill also updates notice requirements for hospitals' financial assistance policies and prohibits hospitals from filing civil actions to collect debts below a specified threshold. These changes directly affect hospitals and patients facing medical debt, aiming to improve access to care for low- and middle-income residents.

Issues: ✓ Healthcare

Bill status signed all 5 stages cleared

Introduction

Oct 2024

Committee Review

Mar 2025

House of Delegates Passage

Apr 2025

Senate Passage

Mar 2025

Signed into Law

May 2025

Introduced Oct 25, 2024 Signed May 20, 2025

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What changed between versions

First - Hospitals - Financial Assistance and Collection of Debts - Policies → Third - Hospitals - Financial Assistance and Collection of Debts - Policies · 5 edits

MODERATE

The bill was amended to add a new provision excluding hospital consumer debt contracts from Maryland's general statute of limitations, and reorganized which sections of the Annotated Code of Maryland are being repealed and reenacted. The substantive policy content regarding financial assistance policies, payment plans, and debt collection restrictions remains largely unchanged from the previous version.

Scope change

The bill now includes a new provision (Section 5-102) that extends the statute of limitations for hospital debt collection cases from the general three-year period to 12 years for contracts between consumers and hospitals, while the rest of the bill's scope regarding financial assistance policies remains the same.

TIMELINE

Added a new statute of limitations provision (Section 5-102) that extends the time limit for filing civil actions to collect hospital debt from 3 years to 12 years for contracts between consumers and hospitals.

TECHNICAL

Reorganized which sections of the Annotated Code of Maryland are repealed and reenacted, moving some sections from the Health-General article to the Courts and Judicial Proceedings article.

Added co-sponsors to the bill (Delegates Pena-Melnyk, Cullison, Bagnall, Bhandari, Guzzone, Hill, S. Johnson, Kaiser, Kerr, Lopez, Martinez, Rosenberg, Taveras, White Holland, Woods, and Woorman).

Added committee report status showing the bill was approved with amendments and adopted by the House.

Removed the original title page information and replaced it with updated bill tracking information including the new co-sponsors and committee status.

Floor votes · Senate Mar 12, 2025 · House of Delegates Feb 27, 2025

How they voted

39–7

Passed

Total votes 46

Mar 12, 2025

D Democratic33

33 Yea

100% Yea

R Republican13

6 Yea 7 Nay

53% Nay

Vote distribution

All Yea All Nay Mixed No data

Full legislative history

Actions timeline

Total actions

Key actions

Committee

May 20, 2025

Signed into law

Approved by the Governor - Chapter 693

executive

Apr 1, 2025

Lower · Passed

Returned Passed

lower

Mar 31, 2025

Upper · Passed

Third Reading Passed

upper

Mar 25, 2025

Upper · Passed

Favorable Adopted Second Reading Passed

upper

Mar 24, 2025

Upper · Passed

Favorable Report by Finance

upper

Mar 12, 2025

Senate · Passed

Senate Vote: pass (39-7)

senate

Mar 7, 2025

Committee

Referred Finance

upper

Mar 6, 2025

Lower · Passed

Third Reading Passed

lower

Mar 4, 2025

Lower · Passed

Favorable with Amendments {

lower

Mar 3, 2025

Lower · Passed

Favorable with Amendments Report by Health and Government Operations

lower

Feb 27, 2025

House Of Delegates · Passed

House of Delegates Vote: pass (109-24-6)

house of delegates

Jan 8, 2025

Committee

First Reading Health and Government Operations

lower

Oct 25, 2024

Introduced

Pre-filed

lower

16 primary · 0 co-sponsors