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Hospital facility fee bill narrowed as Colorado legislative session end nears [1]
['Sara Wilson', 'More From Author', '- May']
Date: 2023-05
Colorado lawmakers want to increase transparency around the fees that hospitals charge at outpatient facilities.
Facility fees are charges that hospitals bill to cover costs of providing care and other operational expenses. It is distinct from insurance premiums, copays and other office visit charges.
Sponsors of a facility-fee bill say that as hospitals merge and acquire more sites to serve as outpatient clinics, facility fees are becoming more common. They can cause confusion and frustration for patients who don’t expect or understand the extra charge.
Bill sponsors say the fees amount to a type of surprise billing.
“We cannot continue to allow hospitals to rake in record profits while Colorado families struggle to pay for rent and groceries,” bill sponsor Sen. Lisa Cutter, a Littleton Democrat, said at a press conference last week.
House Bill 23-1215 would prohibit providers affiliated with a hospital or health system from charging facility fees for preventative care in outpatient settings, with exemptions for rural hospitals that are the only one in the area. A transparency provision would require that those providers notify patients that they charge the fee and include it on an itemized bill.
Additionally, the bill would create a study on the scope of facility fees in the state and their impact on the health care system, including the number of patients who faced facility fees, the total amount collected in facility fees and the most frequent medical codes used.
Now, after this terrible experience, I’m afraid to take my son to the doctor. – Natalie Zelinska
“It will allow us to gain critical insight into when and why these hospitals are charging facility fees, their impact on consumers and the mechanisms through which hospitals cover their costs,” bill sponsor Rep. Emily Sirota, a Denver Democrat, said.
The bill was heavily amended from its introduced version, which would have banned fees for a wider range of outpatient services, as well as for telehealth services.
It passed the House on April 18 and made it through its first Senate committee hearing last week. The Senate Appropriations Committee laid it over on Tuesday.
Afraid to see a doctor
Natalie Zelinska said a $1,500 facility fee for her son’s routine cardiology appointment at Children’s Hospital Colorado to manage his congenital heart disease came as a shock. Their previous cardiologist at Denver Health, who had moved out of state, had a fee of around $55 with insurance.
“The services were exactly the same. I spent weeks pushing back against this fee with no success. Now, after this terrible experience, I’m afraid to take my son to the doctor,” she said.
If HB-1215 passes, patients like Zelinska and her son would have a better idea of the facility fee before they receive care. Providers would need to notify patients in plain language the amount of the possible facility fee when an appointment is scheduled.
Connecticut and New York have bans on some facility fees in place.
The bill faces opposition from groups including Children’s Hospital Colorado, Centura Health, the Colorado Chamber of Commerce, Denver Health and University of Colorado Health.
“Facility fees are an important part of what we are able to charge,” former Lt. Gov. Donna Lynne, who now serves as the CEO of Denver Health, told House committee members in March. “The services provided by facility fees are essential to the delivery of care.”
She rejected the idea that facility fees are akin to surprise bills, which typically refers to an unexpected bill from an out-of-network provider.
The Colorado Hospital Association moved from an opposed position to an amend position with the additional amendments.
“CHA and its member hospitals appreciate the detailed and thoughtful work of the sponsors and proponents as we seek to ensure that (the bill) does not risk access to care for Coloradans. We particularly appreciate the agreement that there is a significant need to study the impact of facility fees on health care in the state before making changes that could otherwise harm patient access,” Vice President of Government Affairs Joshua Ewing wrote in an email. “We will continue to work with the proponents and sponsors to ensure that patient protections are included in the new bill language about preventive care services.”
The legislative session ends on Monday.
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