Balance Billing Laws in Maryland
Your medical billing rights and protections in Maryland.
Maryland enacted HB 1419 (2018) 'Surprise Billing — Consumer Protection,' one of the first states to pass comprehensive surprise billing protections. The law prohibits balance billing for emergency services and for non-emergency services at in-network facilities when patients have no choice of provider, and requires disputes to be settled between providers and insurers.
Key Protections in Maryland
Emergency services: Patients cannot be balance billed for emergency services; cost-sharing limited to in-network amounts
Out-of-network at in-network facility: Non-emergency services at in-network facilities are protected when the patient had no meaningful choice of provider
Dispute resolution: Maryland's Health Education and Advocacy Unit (HEAU) can assist with mediation of billing disputes
Network adequacy: Maryland requires health plans to maintain adequate networks to minimize instances of involuntary out-of-network care
Filing Information
Within 3 years of the date of service for Maryland complaints
Additional Notes
Maryland consumers can also contact the Office of the Attorney General's Health Education and Advocacy Unit (HEAU) at 1-877-261-8807 for assistance with billing disputes. Self-funded ERISA plans fall under federal NSA.
How to File a Complaint in Maryland
Gather Your Documentation
Collect your itemized medical bill, Explanation of Benefits (EOB) from your insurer, any prior authorization documents, and written communications with the provider or insurance company.
File with the State Regulator
Submit your complaint to the Maryland Insurance Administration. Include all supporting documents and a clear description of the billing dispute.
File complaint with Maryland Insurance AdministrationFile with CMS if Federal Protections Apply
If your dispute involves the No Surprises Act (emergency care or out-of-network providers at in-network facilities), you can also file directly with the Centers for Medicare & Medicaid Services.
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