Maryland Patient Billing Rights

Know your rights as a patient in Maryland. From surprise billing protections to financial assistance programs, here's what the law says about your medical bills.

Hospital Data Surprise Billing Financial Assistance Medical Debt FAQ File a Complaint

Maryland Hospital Pricing at a Glance

Based on CMS cost report data from 41 hospitals in Maryland.

41
Hospitals Tracked
1.4×
Avg Charge-to-Cost Ratio
$127,800
Avg Charge per Stay
$462,000
Annual Discharges

Maryland hospitals charge an average of 1.4× their actual costs. The average hospital stay is billed at $127,800, while the actual cost is $89,600. Compare prices at specific hospitals →

Federal No Surprises Act (2022) — Applies in Maryland

The federal No Surprises Act protects all Maryland patients, regardless of state laws:

  • No surprise bills for emergency services at any hospital, in-network or out-of-network.
  • No balance billing from out-of-network providers at in-network facilities (anesthesiologists, radiologists, etc.).
  • No surprise bills for air ambulance services from out-of-network providers.
  • Good faith estimates for uninsured/self-pay patients — dispute if the bill exceeds the estimate by $400+.
  • Applies to all insurance types including self-funded employer plans not covered by state law.

Surprise Billing Protections

All-Payer Rate Setting System & HB 1122 (2021) protects Maryland patients from unexpected out-of-network medical bills.

  • Maryland has a unique all-payer rate-setting system — the Health Services Cost Review Commission (HSCRC) sets hospital rates.
  • All patients (insured, uninsured, Medicare, Medicaid) are charged the same rates at each hospital.
  • Surprise billing is less of an issue because hospital rates are regulated, but HB 1122 adds explicit protections.
  • Out-of-network providers at in-network facilities cannot balance bill patients beyond in-network cost-sharing.
  • Maryland's system results in lower charge-to-cost ratios compared to most states.

What this means for you

If you receive a surprise out-of-network bill, you are not responsible for the balance beyond what you'd pay for in-network care. Contact your insurer and reference the All-Payer Rate Setting System & HB 1122 to dispute any balance bill.

Financial Assistance & Charity Care

Under Maryland Medical Assistance Program & Hospital Financial Assistance (COMAR 10.37.10), hospitals in Maryland must provide financial assistance to qualifying patients.

  • Maryland requires all hospitals to provide financial assistance to patients who qualify based on income.
  • Patients at or below 200% of the Federal Poverty Level qualify for free care at Maryland hospitals.
  • Reduced-cost care is available for patients between 200-300% FPL.
  • The Health Services Cost Review Commission (HSCRC) oversees hospital rates and uncompensated care.
  • Maryland expanded Medicaid, covering adults with incomes up to 138% FPL.

How to apply

  1. Ask the hospital's billing department for a financial assistance application.
  2. Gather proof of income (pay stubs, tax return, benefit letters).
  3. Submit the application — you can often do this even after receiving a bill.
  4. If denied, appeal the decision and contact your state insurance department.

Income threshold: 200% FPL for free care; up to 300% FPL for reduced-cost

Medical Debt Rights in Maryland

Maryland has a 3-year statute of limitations on medical debt (Md. Code, Cts. & Jud. Proc. § 5-101). This is one of the shortest in the nation.

3 years
Statute of Limitations

After 3 years, creditors cannot sue you to collect medical debt in Maryland. The clock starts from the date of your last payment or acknowledgment of the debt.

Your Protections

  • Maryland has one of the shortest statutes of limitations for medical debt at just 3 years.
  • The all-payer system ensures more uniform and regulated hospital pricing.
  • Maryland law limits interest on medical debt judgments.
  • Paid medical debt is removed from credit reports. Medical debt under $500 is excluded.
  • The HSCRC sets uncompensated care targets for hospitals, ensuring charity care availability.

Additional Patient Rights in Maryland

Beyond surprise billing and financial assistance, federal and state law provide these important protections.

Good Faith Estimates

Uninsured or self-pay patients can request a good faith estimate of charges before receiving care. If the final bill exceeds the estimate by $400 or more, you can dispute it through the federal process.

Itemized Bills

You have the right to an itemized bill showing each charge. Review it carefully — billing errors are found in up to 80% of hospital bills according to industry estimates.

Price Transparency

Since 2021, all hospitals must publish their standard charges and negotiated rates online. Use Taven's price comparison tool to see how Maryland hospitals compare.

Payment Plans

Hospitals must offer reasonable payment plans before pursuing collections. Ask about interest-free options and negotiate monthly payment amounts based on your income.

Frequently Asked Questions

What is the statute of limitations for medical debt in Maryland?

Maryland has a 3-year statute of limitations on medical debt (Md. Code, Cts. & Jud. Proc. § 5-101). This is one of the shortest in the nation — after 3 years, creditors cannot sue to collect.

What is Maryland's all-payer rate-setting system?

Maryland is the only state where hospital rates are set by a state commission (HSCRC). All payers — insurance companies, Medicare, Medicaid, and self-pay patients — pay the same regulated rates at each hospital.

Does Maryland require hospitals to provide charity care?

Yes. Maryland hospitals must provide financial assistance to qualifying patients. Those at or below 200% FPL qualify for free care, and reduced-cost care is available up to 300% FPL.

Why are Maryland hospital charges different from other states?

Maryland's all-payer system regulates hospital rates, resulting in a charge-to-cost ratio of about 1.4× — much lower than the national average of 3-5×. This means bills more closely reflect actual costs.

Where do I file a complaint about a medical bill in Maryland?

Contact the Maryland Insurance Administration (MIA) at 1-800-492-6116 or file online. For hospital rate issues, contact the HSCRC. For billing fraud, contact the Maryland Attorney General.

How to File a Complaint in Maryland

If a hospital or insurance company is violating your rights, you can file a formal complaint.

Maryland Insurance Administration (MIA)

For insurance-related complaints: claim denials, balance billing, network issues.

📞 1-800-492-6116

File a complaint →

Maryland Attorney General

For deceptive billing practices, fraud, or consumer protection violations.

File a complaint →

Hospitals in Maryland

Compare prices at 41 hospitals across Maryland. Click any hospital to see their procedure prices and negotiated rates.

Browse all 41 Maryland hospitals →

Maryland Resources

MD Insurance Administration MD Health Services Cost Review Commission MD Attorney General — Consumer Protection MD Dept. of Health

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🔗 Helpful Resources

🔍 Free Bill Review Tool ⚔️ How to Fight a Hospital Bill 💬 Medical Bill Negotiation Guide ✉️ Appeal & Dispute Letters Why Is My Hospital Bill So High? ⚖️ All State Patient Rights