Debt Collection Regulations Focus of Latest Maryland Stakeholder Working Group Meeting

Aligning requirements of the state’s new medical debt law with existing debt collection regulations was discussed in the Feb. 28 meeting of the workgroup, which is focused on hospital payment plan guidelines.

03/14/2022 7:00 A.M.

4 minute read

Maryland’s Health Services Cost Review Commission’s (HSCRC) Workgroup on Hospital Payment Plan Guidelines discussed resources to ensure debt collectors have guidance on requirements in the state’s new medical debt law during its Feb. 28 meeting. The meeting was the third in a series to review 15 total draft guidelines before presenting updates to the HSCRC commission.

Of note during the meeting, one of the draft guidelines to comply with the law sparked conversation about existing requirements for debt collectors in Maryland when it comes to payment plans with their health care provider clients.

One draft guideline discussed by the HSCRC Feb. 28 states, “A debt collector shall be entitled to service payment plans entered into by its hospital clients, per the terms and conditions established by the hospital. Hospitals shall require that debt collectors operating under contract with the hospital abide by the requirements of these guidelines.”

The HSCRC Workgroup, which includes consumer advocates, health care providers, state regulators, consumer representatives and financial services industry members, discussed how hospitals use different types of vendors for bill collection and financial assistance (and insurance) eligibility and ensuring those processes will comply with the new law.

Anyone collecting in Maryland needs to comply with Maryland law, said Jedd Bellman, assistant commissioner at the Office of the Maryland Commissioner of Financial Regulation, adding that representatives of the financial services industry have reached out to the office about concerns with implementing the draft guidelines.

In addition to the draft guidelines and audit procedures for hospitals, the HSCRC is considering releasing Frequently Asked Questions (FAQs) in partnership with the Office of the Maryland Commissioner of Financial Regulation to help provide clarity for regulated entities.

“For [companies] to maintain a license and operate in a safe and sound manner they need to this correctly,” Bellman said. “Our goal is to try to create certainty and clarity around that. The FAQs would be our expectation[s] around how debt collectors should operate in connection with their customers, the hospitals, in compliance with this new requirement. We are looking to provide guidance … as one voice.”

HSCRC stakeholder group and ACA International member Leslie Bender, IFCCE, senior counsel at Clark Hill Law, also asked during the meeting how consumer complaint options could fit in with the finalized guidelines.

“Because this is a complex regime with hospitals and debt collectors, we need to be very clear who has oversight and in which cases,” said Marceline White executive director of the Maryland Consumer Rights Coalition.

Bellman said his office coordinates with the financial services industry, the North American Collection Agency Regulatory Association and the Consumer Financial Protection Bureau on complaint processes by sharing information and coordinating investigations when consumer complaints occur.

“We just need to make sure that consumers understand the avenue,” Bellman said. “We do take our consumer services obligations under law very seriously.”

HSCRC workgroup member Brett McCone, senior vice president of health care payment for the Maryland Hospital Association, said the first step if there is a complaint or a concern is to reach out to the hospital, and that should be considered in the draft guidelines.

Bender added that perhaps a consumer education component should be added to the draft guideline on payment plans that debt collectors service for their hospital clients, as discussed during the Feb. 28 meeting.

“We are always happy and eager to participate with patient advocates in consumer education programs,” Bender said. “Collection agencies under the FDCPA and in Maryland work hard to be responsive to consumer inquiries and complaints. Collection agencies servicing health care receivables are problem solvers who live by compliance programs designed to be responsive to patients and their families.”

Guidelines Finish Line

Under the Maryland medical debt law, a hospital must annually submit its policy on the collection of debts owed by patients as well as a specified report to the HSCRC. The HSCRC must compile these submissions into an annual medical debt collection report.

The HSCRC is working toward updating the draft guidelines for consideration at the April 13 commission meeting, which would open a public comment period on the guidelines. The final draft guidelines would be presented at the May commission meeting and, once officially finalized, they would be incorporated into regulations under the law.

ACA and the Mid-Atlantic Collectors Association continue to work closely with the Maryland Office of the Commissioner of Financial Regulations as it considers regulations and guidance to implement the new law.

View a recording of the HSCRC’s January and February meetings here.

Read more about the Maryland law and other states implementing medical debt laws in Collector magazine.

Related Content from ACA International:

Hospital Payment Guidelines Under Review by Maryland Stakeholder Working Group

If you have executive leadership updates or other member news to share with ACA, contact our communications department at [email protected] View our publications page for more information and our news submission guidelines here.

If you have executive leadership updates or other member news to share with ACA, contact our communications department at [email protected]. View our publications page for more information and our news submission guidelines here.


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