Hospitals - Emergency Pregnancy-Related Medical Conditions - Procedures, the official text

WES MOORE, Governor                  Ch. 789

Chapter 789

                   (House Bill 372)

AN ACT concerning

Hospitals – Emergency Pregnancy–Related Medical Conditions – Procedures

FOR the purpose of requiring a hospital to conduct screening on a patient presenting at an
         emergency department of the hospital to determine whether the patient has an
         emergency pregnancy–related medical condition; establishing requirements and
         prohibitions related to the treatment and transfer of a patient who has an emergency
         pregnancy–related medical condition; requiring a hospital to allow the termination
         of a pregnancy in certain circumstances; prohibiting a hospital from taking adverse
         action against a provider for not transferring a patient who is not stabilized or
         against a hospital employee if the employee reports a violation of this Act; and
         generally relating to emergency pregnancy–related medical conditions and hospitals.

BY adding to
         Article – Health – General
         Section 19–342.1
         Annotated Code of Maryland
         (2023 Replacement Volume and 2025 Supplement)

BY repealing and reenacting, with amendments,
         Article – Health – General
         Section 20–214(b)
         Annotated Code of Maryland
         (2023 Replacement Volume and 2025 Supplement)

         SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:

                   Article – Health – General

19–342.1.

        (A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.

                (2) “EMERGENCY PREGNANCY–RELATED MEDICAL CONDITION”

MEANS A MEDICAL CONDITION THAT PRESENTS IN A PREGNANT PATIENT THROUGH
ACUTE SYMPTOMS OF SUFFICIENT SEVERITY AND FOR WHICH THE ABSENCE OF

IMMEDIATE MEDICAL ATTENTION COULD BE REASONABLY EXPECTED TO RESULT IN:

                   –1–
Ch. 789    2026 LAWS OF MARYLAND

           (I) PLACING THE HEALTH OF THE PATIENT IN SERIOUS

JEOPARDY;

           (II) SERIOUS IMPAIRMENT TO BODILY FUNCTIONS; OR

           (III) SERIOUS DYSFUNCTION OF ANY BODILY ORGAN OR BODY

PART.

                (3) “STABILIZE” MEANS, FOR AN EMERGENCY PREGNANCY–RELATED
MEDICAL CONDITION, TO PROVIDE THE MEDICAL TREATMENT NECESSARY TO
ALLEVIATE THE CONDITION OR ENSURE, WITHIN REASONABLE MEDICAL
PROBABILITY, THAT NO MATERIAL DETERIORATION OF THE CONDITION IS LIKELY

TO RESULT FROM OR OCCUR DURING THE TRANSFER OF THE PATIENT FROM THE

FACILITY.

        (B) THIS SECTION APPLIES ONLY TO A HOSPITAL WITH AN EMERGENCY
DEPARTMENT.

        (C) IF A HOSPITAL DETERMINES THAT A PATIENT HAS AN EMERGENCY
PREGNANCY–RELATED MEDICAL CONDITION, THE HOSPITAL SHALL:

                (1) USING THE STAFF AND FACILITIES AVAILABLE TO THE HOSPITAL,

PROVIDE FURTHER EXAMINATION AND THE TREATMENT REQUIRED TO STABILIZE

THE EMERGENCY PREGNANCY–RELATED MEDICAL CONDITION, INCLUDING THE

TERMINATION OF A PREGNANCY WHEN THE TERMINATION IS MEDICALLY

NECESSARY TO STABILIZE THE PATIENT; OR

           (2) TRANSFER THE PATIENT TO ANOTHER MEDICAL FACILITY.

        (D) A HOSPITAL SHALL ALLOW THE TERMINATION OF A PREGNANCY AT THE
HOSPITAL IF THE PATIENT’S TREATING HEALTH CARE PRACTITIONER DETERMINES
TERMINATION IS MEDICALLY NECESSARY TO STABILIZE A PATIENT.

        (E) (1) A HOSPITAL IS CONSIDERED TO HAVE MET THE REQUIREMENTS
OF THIS SECTION IF, AFTER OFFERING FURTHER EXAMINATION AND TREATMENT OR
TRANSFER TO THE PATIENT OR THE PATIENT’S REPRESENTATIVE AND INFORMING
THE PATIENT OR PATIENT’S REPRESENTATIVE OF THE RISKS AND BENEFITS OF
FURTHER EXAMINATION AND TREATMENT OR TRANSFER:

                         (I) A PATIENT OR THE PATIENT’S REPRESENTATIVE REFUSES
TO CONSENT TO FURTHER EXAMINATION AND TREATMENT; OR

           –2–
WES MOORE, Governor  Ch. 789

                         (II) A PATIENT OR THE PATIENT’S REPRESENTATIVE REFUSES
TO CONSENT TO A TRANSFER TO ANOTHER MEDICAL FACILITY.

                (2) A HOSPITAL SHALL TAKE REASONABLE STEPS TO SECURE

WRITTEN INFORMED CONSENT TO THE REFUSAL OF AN EXAMINATION OR
TREATMENT OR TRANSFER UNDER THIS SUBSECTION FROM THE PATIENT OR THE

PATIENT’S REPRESENTATIVE.

        (F) IF A PATIENT HAS AN EMERGENCY PREGNANCY–RELATED MEDICAL
CONDITION THAT HAS NOT BEEN STABILIZED, THE HOSPITAL MAY NOT TRANSFER
THE PATIENT UNLESS THE TRANSFER IS DONE CONSISTENT WITH 42 U.S.C. §
1395DD.

        (G) A HOSPITAL MAY NOT PENALIZE OR TAKE OTHER ADVERSE ACTION,
INCLUDING AN ACTION RELATED TO DISCHARGE, PROMOTION, DEMOTION,
SUSPENSION, COMPENSATION, TRAINING OPPORTUNITIES, STAFF PRIVILEGES, OR
ADMITTING PRIVILEGES, AGAINST:

                (1) A TREATING HEALTH CARE PROVIDER IF THE PROVIDER REFUSES

TO AUTHORIZE THE TRANSFER OF A PATIENT WITH AN EMERGENCY

PREGNANCY–RELATED MEDICAL CONDITION THAT HAS NOT BEEN STABILIZED;

                (2) A TREATING HEALTH CARE PROVIDER IF THE PROVIDER’S

TREATMENT OF THE PATIENT IS CONSISTENT WITH THE MEDICAL STANDARDS OF

CARE THAT, IN THE PROVIDER’S CLINICAL JUDGMENT, WERE NECESSARY TO
STABILIZE THE PATIENT; OR

                (3) A HOSPITAL EMPLOYEE IF THE EMPLOYEE REPORTS A VIOLATION
OF THIS SECTION.

        (H) A HOSPITAL THAT NEGLIGENTLY VIOLATES THIS SECTION IS SUBJECT
TO A CIVIL PENALTY OF:

                (1) FOR A HOSPITAL WITH 100 OR MORE BEDS, NOT MORE THAN
$50,000 FOR EACH VIOLATION; OR

                (2) FOR A HOSPITAL WITH FEWER THAN 100 BEDS, NOT MORE THAN
$25,000 FOR EACH VIOLATION.

        (I) (1) THE DEPARTMENT SHALL STAY A FINAL DECISION ON A

POTENTIAL VIOLATION IF THERE IS AN ONGOING FEDERAL INVESTIGATION UNDER

42 U.S.C. § 1395DD REGARDING THE SAME INCIDENT.

–3–
Ch. 789  2026 LAWS OF MARYLAND

                (2) IF A FEDERAL INVESTIGATION UNDER 42 U.S.C. § 1395DD
RESULTS IN A FINE BEING IMPOSED FOR THE SAME INCIDENT, THE DEPARTMENT

SHALL SUBTRACT THE AMOUNT OF THE FEDERAL FINE FROM THE MAXIMUM

POTENTIAL FINE UNDER THIS SECTION FOR THE SAME INCIDENT.

                (3) (I) SUBJECT TO SUBPARAGRAPH (II) OF THIS PARAGRAPH, IF A
FEDERAL INVESTIGATION UNDER 42 U.S.C. § 1395DD RESULTS IN A FINE BEING
IMPOSED FOR THE SAME INCIDENT WITHIN 2 YEARS AFTER THE DEPARTMENT
IMPOSES A FINE UNDER THIS SECTION, THE DEPARTMENT SHALL REFUND THE
HOSPITAL AN AMOUNT EQUAL TO THE AMOUNT OF THE FEDERAL FINE.

                         (II) THE AMOUNT REFUNDED UNDER SUBPARAGRAPH (I) OF

THIS PARAGRAPH MAY NOT EXCEED THE AMOUNT OF THE FINE IMPOSED BY THE

DEPARTMENT FOR THE SAME INCIDENT.

20–214.

        (b) (1) [A] EXCEPT AS PROVIDED IN § 19–342.1 OF THIS ARTICLE, A
licensed hospital, hospital director, or hospital governing board may not be required:

                         (i) To [permit] ALLOW, within the hospital, the performance of any
medical procedure that results in artificial insemination, sterilization, or termination of
pregnancy; or

                           (ii) To refer to any source for these medical procedures.

                (2) The refusal to [permit] ALLOW or to refer to a source for these
procedures may not be grounds for:

                           (i) Civil liability to another person; or

                           (ii) Disciplinary or other recriminatory action against the person by
this State or any person.

         SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
October 1, 2026.

Approved by the Governor, May 26, 2026.

         –4–