Fighting Medical Debt in Maryland
I got a medical bill I can't afford — here's what Maryland law says and what to do next.
Statute: Md. Code, Ins. § 19-710.1 (Maryland Balance Billing Protections)
Deadline: 120 days
Penalty: Maryland has a unique all-payer rate-setting system through the Health Services Cost Review Commission (HSCRC). Maryland restricts medical debt credit reporting and has strong balance billing protections
What is fighting medical debt?
Medical debt is the leading cause of bankruptcy in the United States, affecting an estimated 100 million Americans. Recent federal actions have significantly strengthened your rights when dealing with medical debt — including new rules removing most medical debt from credit reports and protections against surprise billing.
The No Surprises Act (effective January 2022) protects you from unexpected bills when you receive emergency care or are treated by an out-of-network provider at an in-network facility without your consent. Additionally, the three major credit bureaus voluntarily removed medical debt under $500 from credit reports in 2023, and the CFPB finalized a rule in January 2025 to remove all medical debt from credit reports, but a federal court vacated that rule in July 2025 (Cornerstone Credit Union League v. CFPB) before it took effect.
What to Do If You Get a Medical Bill You Can't Afford
Step 1: Request an itemized bill. Medical billing errors are extremely common — studies suggest up to 80% of medical bills contain errors. Compare the itemized bill against your insurance Explanation of Benefits (EOB).
Step 2: If you received a surprise bill (out-of-network charges you didn't consent to), file a complaint under the No Surprises Act. Contact your insurer, the provider, and CMS at 1-800-985-3059. You should only owe your in-network cost-sharing amount.
Step 3: Ask the hospital about financial assistance. If the hospital is a nonprofit (most are), they must have a financial assistance policy. Request the application — you may qualify for free or reduced-cost care even with insurance.
Step 4: Negotiate the bill. Hospitals regularly accept less than the full amount. Ask for a reduction, a payment plan with no interest, or offer a lump-sum settlement for a lower amount. Get any agreement in writing.
Step 5: If the debt goes to collections, know your FDCPA rights. Request debt validation in writing within 30 days. Medical debt collectors must follow the same rules as any other debt collector. If the debt is on your credit report, check whether it qualifies for removal under the new credit reporting rules.
How Maryland differs from federal law
Maryland provides meaningful protections for residents dealing with medical debt:
- Short statute of limitations: Maryland's statute of limitations on most consumer debt, including medical debt, is 3 years (MD Code, Courts & Judicial Proceedings § 5-101) — one of the shortest in the country
- Hospital financial assistance: Maryland requires hospitals to have financial assistance policies and to screen patients for eligibility before pursuing collections. The Health Services Cost Review Commission (HSCRC) regulates hospital rates
- Unique rate-setting system: Maryland is the only state with an all-payer hospital rate-setting system through the HSCRC, which sets uniform rates for all payers including uninsured patients — preventing the extreme price disparities seen in other states
- Wage garnishment limits: Maryland limits wage garnishment to the lesser of 25% of disposable earnings or the amount by which weekly earnings exceed 30 times the federal minimum wage (MD Code, Commercial Law § 15-601.1)
- Maryland Medical Debt Protection Act: Provides additional protections against aggressive medical debt collection, including limits on interest rates and requirements for debt collectors
Additional steps in Maryland
Ask the hospital about financial assistance programs before paying. Request an itemized bill and check for errors. File collection complaints with the Maryland AG at (410) 528-8662. Contact Maryland Legal Aid at (410) 539-5340 for free legal help. The HSCRC can be reached at (410) 764-2605.
What you should NOT do
Don't pay a bill you haven't verified. Always request an itemized bill and compare it to your insurance EOB before paying. Errors are extremely common.
Don't put medical debt on a credit card. Medical debt has special protections (lower interest, financial assistance eligibility, credit reporting limits) that you lose once you transfer it to a credit card.
Don't ignore the bill entirely. While medical debt protections are expanding, ignoring bills can lead to lawsuits, wage garnishment, and damage to your credit that could have been avoided through negotiation or financial assistance.
Don't assume you don't qualify for financial assistance. Income thresholds for hospital charity care programs are often surprisingly high (200-400% of the federal poverty level). Apply even if you think your income is too high.
You shouldn't have to hire a lawyer to assert your rights.
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Generate your medical bill dispute →This page is general legal information for Maryland, not legal advice for your specific situation. Laws change, and how a statute applies depends on facts we don't know. For advice on your matter, consult a licensed attorney in Maryland.