The bills that the governor signed into law say the hospital rate-setting commission through its regulatory power can set a higher income threshold for free care after reviewing other factors, including the patient profile and the hospital's bottom line.
Colmers yesterday called the final product a "fair compromise," saying the legislature could revisit the minimum standard for charity care after the state further expands Medicaid eligibility.
The law requires hospitals to develop an information sheet that includes how to apply for free and reduced-price care. The sheet must be provided to patients, their family or a representative before discharge.
Nancy Fiedler, a spokeswoman for the Maryland Hospital Association, said the group is eager to start crafting the information sheet with state regulators.
"We supported the legislation and look forward to working with hospitals to continue to do the best we can to serve Marylanders with needs," she said.
Also, hospitals must post information about financial assistance throughout the hospital, including the billing office.
Hospitals that knowingly violate sections of the new law, including a requirement to oversee debt collection contracts, could be fined by the rate-setting commission up to $50,000 per violation.
The Sun's series found that in some cases, hospitals sought to add interest at the legal maximum of 12 percent a year on judgments, going back to 60 days after the patient was discharged. The Maryland Constitution sets interest rates at 6 percent for most debts, but hospital debts have been exempt. The bill prohibits charging prejudgment interest to uninsured patients.
Louise Carwell, senior attorney for consumer law at the Maryland Legal Aid Bureau, said her office will monitor hospital compliance with the new law.
Despite the stricter rules, however, it will be incumbent on consumers to speak out on their own behalf, she said.
"It will have to be enforced and often by the consumer, who will have to bring it into the discussion of a debt collection issue. Things are going to slip by unless the patient is heard. We will be vigilant in how the new law is implemented," she said.
The Sun reported last December that hospital debt-collection lawsuits spiked sharply between 2003 and 2006 before falling slightly in 2007. In all, hospitals filed more than 132,000 of these suits in the past five years, winning at least $100 million in judgments and placing liens on more than 8,000 homes.
The legislature didn't tackle the questions of how assets should be considered in determining eligibility for free or reduced-price care, and the use of liens to enforce debt collection. The newspaper's series found several instances in which people wound up facing lawsuits even though they had little means to pay their bills.
The new law requires the Health Services Cost Review Commission, a seven-member panel appointed by the governor, to form a committee to make recommendations on those topics to the governor by Oct. 1.
