<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".03" citation="COMAR 10.37.13.03" title_num="10" subtitle_num="37" chapter_num="13" heading="Hospital Information Sheet.">
  <paragraph num="A.">
    <text>Each hospital shall develop an information sheet that:</text>
    <paragraph num="(1)">
      <text>Describes clearly:</text>
      <paragraph num="(a)">
        <text>The hospital's financial assistance policy as required in Regulation .06 of this chapter and Health-General Article, §19-214.1, Annotated Code of Maryland; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A patient's legal rights and obligations with regard to hospital billing and collection;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Informs the patient, the patient’s family, the patient’s authorized representative, or the patient’s legal guardian:</text>
      <paragraph num="(a)">
        <text>That the hospital is permitted to bill outpatients a fee, commonly referred to as a facility fee, for their use of hospital facilities, clinics, supplies, and equipment, and nonphysician services, including but not limited to the services of nonphysician clinicians, in addition to physician fees billed for professional services provided in the hospital;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Of the patient’s right to request and receive a written estimate of the total charges for the hospital non-emergency services, procedures, and supplies that reasonably are expected to be provided and billed for by the hospital, in addition to the good faith estimate requirements in 42 U.S.C §2799B-6, the No Surprises Act;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Of the patient’s right to file a complaint with the Commission or jointly with the Health Education and Advocacy Unit of the Maryland Attorney General’s Office against a hospital for an alleged violation of Health-General Article, §§19-214.1 and 19-214.2, Annotated Code of Maryland;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Of the availability of an income-based payment plan; and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>That physician charges, to both hospital inpatients and outpatients, are generally not included in the hospital bill and are billed separately;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Provides contact information for:</text>
      <paragraph num="(a)">
        <text>The individual or office at the hospital that is available to assist the patient, the patient's family, or the patient's authorized representative in order to understand:</text>
        <paragraph num="(i)">
          <text>The patient's hospital bill;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The patient’s rights and obligations with regard to the hospital bill, including the patient’s rights and obligations with regard to reduced-cost medically necessary care due to a financial hardship;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>How to apply for financial assistance;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>How to apply for the Maryland Medical Assistance Program and any other programs that may help pay the bill; and</text>
        </paragraph>
        <paragraph num="(v)">
          <text>How to apply for a payment plan;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>The Maryland Medical Assistance Program;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Filing a complaint with the Commission or jointly with the Health Education and Advocacy Unit of the Maryland Attorney General’s Office against a hospital for an alleged violation of Health-General Article, §§19-214.1 and 19-214.2, Annotated Code of Maryland; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Includes a section that allows the patient to initial that the patient has been made aware of the financial assistance policy.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The information sheet shall be written in:</text>
    <paragraph num="(1)">
      <text>Simplified language;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>At least 12-point type; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The patient’s preferred language or, if no preferred language is specified, each language spoken by a limited English proficient population that constitutes at least 5 percent of the overall population within the city or county in which the hospital is located as measured by the most recent census.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The information sheet shall conform with Health-General Article, §19–342(d)(7) and (10), Annotated Code of Maryland.</text>
  </paragraph>
  <paragraph num="D.">
    <text>The information sheet shall be provided in writing to the patient, the patient’s family, the patient’s authorized representative, or the patient’s legal guardian:</text>
    <paragraph num="(1)">
      <text>Before the patient receives scheduled medical services;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Before discharge;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>With the hospital bill;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>On request; and</text>
    </paragraph>
    <paragraph num="(5)">
      <text>In each written communication to the patient regarding collection of the hospital bill.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>The hospital bill shall include a reference to the information sheet.</text>
  </paragraph>
  <paragraph num="F.">
    <text>The Commission shall:</text>
    <paragraph num="(1)">
      <text>Establish uniform requirements for the information sheet; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Review each hospital's implementation of and compliance with the requirements of this regulation.</text>
    </paragraph>
  </paragraph>
</regulation>