§19–350. Financial Statement

[parts (c) and (d) apply directly to nursing homes]

  • (a) (1) This section applies only to:
      • (i) Related institutions as defined in § 19–301 of this subtitle; and
      • (ii) Hospitals as defined in § 19–301 of this subtitle.
    • (2) Nothing in this section shall apply to charges for services that are set pursuant to § 16–201 of this article.
  • (b) (1) (i) On request of a patient made before or during treatment, a hospital shall provide to the patient a written estimate of the total charges for the hospital services, procedures, and supplies that reasonably are expected to be provided and billed to the patient by the hospital.
      • (ii) The written estimate shall state clearly that it is only an estimate and actual charges could vary.
      • (iii) A hospital may restrict the availability of a written estimate to normal business office hours.
      • (iv) This paragraph does not apply to emergency services.
    • (2) Within 30 days after discharge of an individual from a hospital, the hospital shall give the individual a summary financial statement that clearly describes:
      • (i) The total charges incurred;
      • (ii) If readily ascertainable, a summary of the total charges under the major services categories, including:
        • 1. Room and board;
        • 2. Diagnostic services;
        • 3. Therapeutic services;
        • 4. Emergency room services;
        • 5. Drugs and IV solutions; and
        • 6. Miscellaneous other supplies and services;
      • (iii) If applicable, the name of the primary and secondary insurer to which a claim has been or will be filed on the individual’s behalf;
      • (iv) That charges for services provided by a physician are not included in the total hospital charges and are billed separately; and
      • (v) The individual’s right to request an itemized statement of the account within 1 year of receipt of the summary statement.
    • (3) Within 30 days after an individual’s request as provided under paragraph (2)(v) of this subsection, the hospital shall provide the individual a statement of the account that:
      • (i) Is itemized; and
      • (ii) Describes briefly but clearly each item and the amount charged for it.
  • (c) (1) Unless a related institution contracts with its residents to provide care for an all–inclusive preestablished fee, on demand made within 90 days after service is provided to a resident, the related institution shall give the resident or representative of the resident a financial statement that:
      • (i) Is itemized;
      • (ii) Describes briefly but clearly each item and the amount charged for it; and
      • (iii) Identifies the payor to whom a claim has been forwarded.
    • (2) A related institution may not be required to give a resident more than 1 itemized statement in any 90–day period.
  • (d) (1) On demand made within 30 days after payment of any charge for an individual, a hospital or related institution shall give the individual or representative of the individual a financial statement that:
      • (i) Is itemized; and
      • (ii) Describes briefly but clearly each item and the amount charged for it.
    • (2) A hospital or related institution is subject to a fine of $300 if it fails to:
      • (i) Comply with this subsection; or
      • (ii) Give the individual or representative a reasonable written explanation for any delay in complying with this subsection.
    • (e) A hospital or related institution may not demand or accept final payment or recover for money unless the hospital or related institution has given the financial statements required under this section.