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Three decades ago, Maryland officials devised a novel system — now the only one of its kind — in which a state agency sets hospital rates for all patients. It was designed in part to guarantee hospital care whether patients could afford it or not. Hospitals received $921 million last year to cover costs of providing free and unpaid care, according to the most recent state records, and all hospital patients in Maryland contribute through the rates they pay. But an eight-month investigation by

The Sun

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found that over the past five years some of Maryland's 46 nonprofit hospitals have received millions of surplus dollars from the payment system even as they sued tens of thousands of patients over unpaid bills. Many of these suits have been filed against patients in the poorest areas of the state.

Over the past five years, hospitals across Maryland have filed tens of thousands of lawsuits to collect unpaid bills. The Baltimore Sun, using a sampling of these court cases, created a database of more than $100 million in judgments hospitals won in lawsuits they filed from the start of January 2003 through June 30, 2008. Some hospitals have more cases than others in the sample.
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