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Uniform Financial Assistance Application

With the passage of HB 627 during 2005 Maryland legislative session, each hospital was mandated to develop its own financial assistance policy for providing free care and reduced cost care to low income individuals who lack health care coverage. In addition, the legislation required the development of a common financial assistance form to be utilized by all hospitals, and that each hospital makes its financial assistance policy and the common financial assistance form available to patients upon request.

In an effort to standardize financial assistance requests across all Maryland acute-care hospitals, HSCRC developed the Financial Assistance Application (which must be sent to the individual hospital chosen by the applicant). For more information about a hospital's financial assistance policy, please contact the individual hospital. Website links to Maryland's 42 acute care hospitals are listed here.

Maryland Hospital Patient Information Sheet

According to Health-General §19-214.1(e), Maryland’s acute care hospitals must provide a patient information sheet to patients being discharged from the hospital. The information sheet must include the following:
  1. Description of the hospital’s financial assistance policy;
  2. Description of the patient’s rights and obligations with regard to hospital billing and collection under the law;
  3. Contact information for the individual or office at the hospital that is available to assist the patient, their family or authorized representative with the patients bill, their rights and obligations and information on how to apply for free and reduced care;
  4. Contact information for the Maryland Medical Assistance Program and;
  5. A statement that physician charges are not included in the hospital bill and are billed separately.
HSCRC is working with hospitals to develop Patient Information Sheets in order to fulfill the requirements of the statute, effective June 1. 2009. For more information about the Guidelines for the Patient Information Sheet, please also read the Frequently Asked Questions (FAQs).