Md. bills would protect patients struggling with medical debt

This article was republished with permission from WTOP’s news partners at Maryland Matters. Sign up for Maryland Matters’ free email subscription today.

This content was republished with permission from WTOP’s news partners at Maryland Matters. Sign up for Maryland Matters’ free email subscription today.

A pair of bills aimed at providing protections for hospital patients struggling with medical debt was heard in the House Health and Government Operations Committee Friday.

Del. Robbyn T. Lewis, a Democrat from Baltimore City, told the committee that hospitals filed more than 145,000 lawsuits between 2009 and 2018 against their patients for unpaid medical bills.

These cases were settled in a number of ways, including more than 3,000 instances of bankruptcy. The median amount of medical debt retained by these patients was $944.

“Those 3,000 patients — those are our constituents,” she said during the hearing.

Sponsored by Lewis, HB1420 would expand eligibility for hospital-provided financial assistance and increase the number of those who qualify for free or charity care, and would also help establish a process for hospitals to more accurately determine who does and does not qualify for that assistance.

“This bill is designed to help people without the ability to pay medical bills,” she said before the committee.

The Maryland Hospital Association is supportive of Lewis’ bill with the addition of some amendments.

Collection methods

The Medical Debt Protection Act, HB1081, sponsored by Del. Lorig Charkoudian, a Democrat from Montgomery County, would put restraints on the methods that hospitals use to collect their unpaid debts.

The legislation set up the creation of payment plans and limits to negative hits to patients’ credit reports. It would also prohibit institutions from filing court actions against people who owe less than $5,000, pursuing liens on their homes or garnishing their wages, among other prohibitions.

Charkoudian said that this legislation would allow hospitals to pursue necessary debt collection in a method “that is not predatory.”

“It is absolutely unacceptable, that in one of the richest states in the country, you can get sick and, as a result, lose everything,” Charkoudian said at a pre-hearing news conference hosted by the Maryland Consumer Rights Coalition.

Maryland Hospital Association President Bob Atlas testified during the bill’s hearing that his organization is “resolute” in looking into improving the way that hospitals handle patient debt, but that Charkoudian’s proposed bill may induce “unintended, adverse consequences,” such as inducing a climb in the cost of Medicaid and uncompensated care.

The Maryland Hospital Association is in favor of the bill, but submitted an amendment requesting further study of its proposed policies in a work group.

“Please do not take these concerns lightly,” Atlas said.

During the news conference, consumer protection attorney Kat Hyland said that she sees medical debt cases being filed at lightning speed — sometimes for debts as low as a few hundred dollars.

“What really gets me at the core of this economic rights issue is the fact that these are people who are sick,” she said. “These are people who are in recovery and in medical treatment who now have to bear legal expenses and find additional resources to go represent themselves in court in what could be handled in a completely different way.”

Charkoudian said she knows there are alternative methods because not every hospital chooses to litigate. But many do, and it impacts the lives of many Marylanders who are left to dig themselves out.

‘I couldn’t pay’

For example, five years ago, Verdell Clark had unpaid medical bills. She also still had cancer.

In written testimony read in her absence at the hearing Friday, Clark painted a picture of stacking medical debts and incoming calls from the Johns Hopkins Hospital’s financial department.

“At that point, I wasn’t concerned about the bills because I was sick and I knew I couldn’t pay the bills,” she wrote.

So she paid it no mind.

After her return to work, Clark was refused medical care several times because of her outstanding debts, and found herself being sent to the hospital’s financial department to settle up before being seen.

She was eventually sued, and when she arrived at the wrong courthouse was arrested, handcuffed and made to wait in a holding cell in the basement until a judge dismissed her case.

Despite the trauma, debt and newly accrued bad credit, Clark said that she was able to pick herself back up.

“I was able to get through it,” she wrote. “There are other people who are not able to get through it.”

Clark isn’t alone. Last May, the Baltimore Sun reported that Johns Hopkins had pursued more than 2,000 lawsuits against debtor patients throughout the course of a decade.

Johns Hopkins nurse Josh Pickett said that, as a hospital worker, he had no idea that he had been complicit in the financial burden of his patients.

“When I learned that thousands of patients were being targeted by Maryland hospitals … I was shocked,” he stated. “When I learned that my hospital was a top offender, I was horrified.”

Pickett said patient fear of medical debt often causes them to avoid treatment, which exacerbates health problems and can lead to even bigger medical bills.

“The cycle of fear and stress generated by wealthy hospitals as they prey on vulnerable patients stops today,” he said.

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