# Maryland SB 0981: Hospitals - Financial Assistance and Collection of Debts - Policies Maryland SB 0981, Hospitals - Financial Assistance and Collection of Debts - Policies, is a 2025 Regular Session Senate bill sponsored by Stephen S. Hershey (Republican); status signed, last action 2025-05-20 (Approved by the Governor - Chapter 694); PRIA reads it as touching household money (as of 2026-10-17). - Canonical: https://policyrisk.com/state-bill/MD-SB0981-2025RS - As of: 2026-10-17 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Bill: Maryland SB 0981 - State: Maryland - Session: 2025 Regular Session - Title: Hospitals - Financial Assistance and Collection of Debts - Policies - Status: signed - Chamber: Senate - Introduced: 2025-02-03 - Last action: 2025-05-20, Approved by the Governor - Chapter 694 - Sponsor: Stephen S. Hershey (Republican) - Cosponsors: 9 - Subjects: Health Care Facilities and Regulation, Debt Collection -see also- Attachments and Garnishments, Hospitals -see also- Clinics; State Hospitals, Low-Income, Medical Assistance, Medical Treatments, Notices, Reports, Standards and Best Practices, Time - Touches household money: yes - Roll calls: 2 (168 yes, 11 no in all) - Economic provisions PRIA read: 9 ## Summary No summary available. ## Bill overview: provisions PRIA read - Lower hospital bills for eligible patients: benefit, high. Beginning October 1, 2025, hospitals must provide free medically necessary care at family incomes up to 200% of the federal poverty level. For eligible patients, minimum cuts in regulated hospital out-of-pocket costs are 75% at 201%–250% of poverty and 60% above 250%–300%. For patients qualifying t… - Fewer hospital lawsuits and clearer warnings: benefit, medium. Hospitals cannot sue over outstanding hospital debt of $500 or less. They must wait until after 240 days from the first bill to send the required pre-lawsuit notice. That notice must arrive by certified and first-class mail at least 45 days before filing suit. It must use simple language, at least… - Hospital debt cannot threaten patients' homes: benefit, medium. Hospitals cannot place liens on patients' primary homes or force their sale or foreclosure to collect hospital debt. They cannot seek arrest warrants or court orders to seize patients, or garnish wages of patients eligible for assistance. Estate claims are barred when hospitals knew the patient qua… - Hospitals cannot sell patients' debt: benefit, medium. Hospitals cannot sell patient debt and must actively oversee collection contracts. Hired collectors must follow hospital policies, address possible assistance eligibility, and forward patient complaints. Hospitals and collectors are each legally responsible for covered collection requirements. Hosp… - Stronger credit protections for hospital patients: benefit, medium. Hospitals cannot report negative credit information during the first 240 days after providing the initial bill. They cannot report debt for patients who were uninsured or eligible for free or reduced-cost care when treated. Qualifying insurance appeals and assistance reconsiderations block negative… - More time to seek hospital help: benefit, medium. Patients have 240 days after receiving their first hospital bill to apply for help and report changed finances. Hospitals must record acknowledgment of the assistance notice before discharge, use a simplified state application, and avoid burdensome paperwork. They must decide completed applications… - Refunds for patients qualifying for free care: benefit, medium. Hospitals must refund amounts collected above $25 when patients qualify for free care within 240 days after the first bill. The refund is due within 30 days after the eligibility decision. For patients in means-tested government health plans requiring out-of-pocket payments, the plan's terms govern… - Smaller hospital payments and fewer charges: benefit, medium. Hospitals must offer written installment plans before discharge and share plan information with bills, on request, and in written collection messages. Income-based monthly payments cannot exceed 5% of adjusted gross monthly household income, counting everyone on the same tax return. Plan guidelines… - Stricter free-care rules for meal-program families: cost, medium. A child's school meal enrollment alone does not establish presumed eligibility for free hospital care. The child must be enrolled in free or reduced-cost meals and qualify based on household income. The patient must also be ineligible for Maryland Medical Assistance and the Maryland Children's Heal… ## Sponsors and cosponsors - Sponsor: Stephen S. Hershey (Republican), Senate - Cosponsor: Alonzo T. Washington (Democratic), Senate - Cosponsor: Pamela Beidle (Democratic), Senate - Cosponsor: Carl Jackson (Democratic), Senate - Cosponsor: Dawn Gile (Democratic), Senate - Cosponsor: Antonio Hayes (Democratic), Senate - Cosponsor: Benjamin F. Kramer (Democratic), Senate - Cosponsor: Clarence K. Lam (Democratic), Senate - Cosponsor: Johnny Mautz (Republican), Senate - Cosponsor: Justin Ready (Republican), Senate ## Roll call votes | Date | Chamber | Motion | Result | Yes | No | Other | | --- | --- | --- | --- | --- | --- | --- | | 2025-03-31 | House | Third Reading Passed | pass | 121 | 11 | 3 | | 2025-03-12 | Senate | Third Reading Passed | pass | 47 | 0 | | ## Actions (17) - 2025-05-20: Approved by the Governor - Chapter 694 - 2025-03-31: Returned Passed (Senate) - 2025-03-31: Third Reading Passed (121-11) (House) - 2025-03-28: Favorable Adopted Second Reading Passed (House) - 2025-03-28: Favorable Report by Health and Government Operations (House) - 2025-03-19: Hearing 3/19 at 2:15 p.m. (House) - 2025-03-19: Hearing canceled (House) - 2025-03-15: Hearing 3/19 at 2:30 p.m. (House) - 2025-03-15: Hearing canceled (House) - 2025-03-13: Hearing 3/19 at 1:00 p.m. (House) - 2025-03-13: Referred Health and Government Operations (House) - 2025-03-12: Third Reading Passed (47-0) (Senate) - 2025-03-11: Second Reading Passed with Amendments (Senate) - 2025-03-11: Favorable with Amendments {573125/1 Adopted (Senate) - 2025-03-10: Favorable with Amendments Report by Finance (Senate) - 2025-02-06: Hearing 2/18 at 1:00 p.m. (Senate) - 2025-02-03: First Reading Finance (Senate) ## Bill text - Enacted, 2025-05-20: [PDF](https://mgaleg.maryland.gov/2025RS/Chapters_noln/CH_694_sb0981t.pdf) - Third Reading, 2025-03-11: [PDF](https://mgaleg.maryland.gov/2025RS/bills/sb/sb0981t.pdf) - First Reading, 2025-02-03: [PDF](https://mgaleg.maryland.gov/2025RS/bills/sb/sb0981f.pdf) ## Related bills - HB 0384: Maryland Disability Service Animal Program - Established (vetoed) - SB 0227: Workers' Compensation - Payment From Uninsured Employers' Fund - Revisions (vetoed) - HB 0482: Occupational Licensing and Certification - Criminal History - Predetermination Review Process (vetoed) - SB 0157: Maryland Disability Service Animal Program - Established (vetoed) - HB 1294: Commercial Law - Credit Regulation - Earned Wage Access and Credit Modernization (became law) - HB 0228: Maryland Veterans Trust – Assistance to Members of the Maryland National Guard (signed) ## Sources - [Enacted (PDF)](https://mgaleg.maryland.gov/2025RS/Chapters_noln/CH_694_sb0981t.pdf) - [Third Reading (PDF)](https://mgaleg.maryland.gov/2025RS/bills/sb/sb0981t.pdf) - [First Reading (PDF)](https://mgaleg.maryland.gov/2025RS/bills/sb/sb0981f.pdf) ## Related - [HB 0384: Maryland Disability Service Animal Program - Established](https://policyrisk.com/state-bill/MD-HB0384-2025RS) - [SB 0227: Workers' Compensation - Payment From Uninsured Employers' Fund - Revisions](https://policyrisk.com/state-bill/MD-SB0227-2025RS) - [HB 0482: Occupational Licensing and Certification - Criminal History - Predetermination…](https://policyrisk.com/state-bill/MD-HB0482-2025RS) - [SB 0157: Maryland Disability Service Animal Program - Established](https://policyrisk.com/state-bill/MD-SB0157-2025RS) - [HB 1294: Commercial Law - Credit Regulation - Earned Wage Access and Credit Modernization](https://policyrisk.com/state-bill/MD-HB1294-2025RS) - [HB 0228: Maryland Veterans Trust – Assistance to Members of the Maryland National Guard](https://policyrisk.com/state-bill/MD-HB0228-2025RS) - [Maryland bills](https://policyrisk.com/states/maryland/bills) - [Maryland state hub](https://policyrisk.com/states/maryland) - [All state legislation](https://policyrisk.com/state-bills) Source: PRIA, https://policyrisk.com/state-bill/MD-SB0981-2025RS (as of 2026-10-17).