Hospitals - Medical Debt Collection - Sale of Patient Debt

Cancellation and protections for hospital debt

From July 1, 2025, through June 30, 2028, Maryland hospitals may sell qualifying debt only for cancellation. Buyers must be government units, their contractors, or tax-exempt 501(c)(3) nonprofits, and sale contracts must require cancellation. The hospital services must be at least two years old, with no expected further third-party payment or open insurance appeal. The buyer must find family income at or below 500% of the federal poverty level, or medical debt above 5% of family income. Once sold, patients owe neither the hospital nor buyer any of that debt, interest, fees, or costs. Hospitals must dismiss pending collection cases and cannot collect on the debt or related judgments, assign collection work, or report negative credit information. Buyers must notify patients of cancellation and seek removal of related judgments or negative credit entries; removal is not guaranteed. The Maryland Health Services Cost Review Commission must subtract sale payments from hospitals’ reported unpaid-care amounts.