Free Daily Headlines :

  • COVID-19
  • Vaccine Info
  • Money
  • Politics
  • Education
  • Health
  • Justice
  • More
    • Environment
    • Economic Development
    • Gaming
    • Investigations
    • Social Services
    • TRANSPORTATION
  • Opinion
    • CT Viewpoints
    • CT Artpoints
DONATE
Reflecting Connecticut’s Reality.
    COVID-19
    Vaccine Info
    Money
    Politics
    Education
    Health
    Justice
    More
    Environment
    Economic Development
    Gaming
    Investigations
    Social Services
    TRANSPORTATION
    Opinion
    CT Viewpoints
    CT Artpoints

LET�S GET SOCIAL

Show your love for great stories and out standing journalism

The Basics: CT’s effort to notify patients of added medical fees

  • Health
  • by Arielle Levin Becker and CTMirror Contributor
  • April 23, 2014
  • View as "Clean Read" "Exit Clean Read"

The state House of Representatives Wednesday passed a bill aimed at making sure patients know about extra charges they could face if they get outpatient care at medical offices owned by hospitals. The proposal, which passed unanimously, now goes to the Senate.

What does the bill do?

Medical practices owned by hospitals can charge patients “facility fees” — charges separate from doctor fees that often cost hundreds or thousands of dollars. Many patients say they didn’t realize they would face the additional charges until they got the bill.

basicsThe proposal would require that patients who schedule appointments at medical offices where facility fees are charged receive plain-language notice about the fees.

Here’s an example of what that would mean for patients:

Wilton resident Susan Ferro had a biopsy performed at an outpatient radiology office in 2010 and another in 2012. The first time, her insurance covered the whole bill. But before the second procedure, the medical office was acquired by a hospital, unbeknownst to Ferro. That allowed the office to bill for her 2012 biopsy as if it had been performed in a hospital. And Ferro, whose insurance had a deductible for hospital services, was left with a $4,000 bill.

If the proposal becomes law, hospitals would be required to give patients like Ferro written, plain-language notices saying that facility fees are charged, and that patients might face higher costs there compared to facilities that aren’t hospital-based.

Patients would also get information on the potential cost if they’re scheduled to receive direct care. (If the extent of the services needed or the patient’s insurance coverage isn’t known, the patient would get an estimate based on typical charges at the facility.) Patients wouldn’t get cost estimates for cases that don’t involve direct care, such as a doctor reading a lab result, because it’s harder to estimate the charges ahead of time.

Patients would receive the notice before the appointment if it’s scheduled at least 10 days in advance, so they could check if their insurance covers the fee or schedule an appointment elsewhere. If not, they’d receive the notice when they arrive at the facility. Patients getting emergency care would need to be notified as soon as practicable after being stabilized.

The bill also includes provisions aimed at making patients aware that the medical offices they’re visiting are connected to a hospital. Hospital-based facilities would also have to prominently display notice that the facility is part of a hospital and that if it charges a facility fee, patients might have to pay more there than at a facility that isn’t hospital-based.

Hospital-based facilities would also have to state the name of the hospital or health system they belong to on their signs, marketing materials, websites and stationery.

What does the bill not do?

The bill doesn’t affect hospitals’ ability to charge facility fees or limit how much they can charge.

Who does it affect?

Patients who receive outpatient services. Hospitals are increasingly buying up physician practices and opening outpatient facilities outside their main campuses, meaning that more patients could potentially be subject to facility fees.

What started it?

Many patients who have been surprised by hefty facility fees have complained to state officials. State Healthcare Advocate Victoria Veltri and Attorney General George Jepsen in particular have pushed for hospitals to give patients better notice about the fees.

According to a survey by Jepsen’s office, 22 of 29 Connecticut hospitals said they charge facility fees in outpatient departments (another one stopped the practice because of patient confusion and dissatisfaction).

What’s the debate?

Hospital officials say the higher fees reflect the higher costs and standards that hospital-based medical practices face. (A recent report released by Jepsen’s office questioned that assertion, noting that hospital-owned practices have other financial advantages, including commanding higher fees from insurers and economies of scale for purchasing.)

Although hospital officials stand by their right to charge facility fees, they agreed earlier this year to a voluntary policy that recommends that hospitals give written notice to patients at all off-campus locations of what their potential financial liability would be, if possible.

Jepsen and Veltri argued that legislation was needed to go beyond what the hospitals had voluntarily agreed to, and the Connecticut Hospital Association supported the facility fee bill.

How they voted?

The House passed the bill unanimously.

The proposal previously passed the General Law and Public Health committees unanimously.

What’s next?

The bill goes to the Senate. Gov. Dannel P. Malloy’s budget director, Benjamin Barnes, testified in favor of the bill at the committee level, an indication that the governor would be likely to sign it.

Related Stories
  • As hospitals buy medical practices, patients face thousands of dollars in new charges
  • Jepsen takes aim at health care ‘facility fees’
  • CT hospitals’ group recommends notifying patients on facility fees, costs

Sign up for CT Mirror's free daily news summary.

Free to Read. Not Free to Produce.

The Connecticut Mirror is a nonprofit newsroom. 90% of our revenue comes from people like you. If you value our reporting please consider making a donation. You'll enjoy reading CT Mirror even more knowing you helped make it happen.

YES, I'LL DONATE TODAY

ABOUT THE AUTHOR

Arielle Levin Becker Arielle Levin Becker covers health care for The Connecticut Mirror. She previously worked for The Hartford Courant, most recently as its health reporter, and has also covered small towns, courts and education in Connecticut and New Jersey. She was a finalist in 2009 for the prestigious Livingston Award for Young Journalists and a recipient of a Knight Science Journalism Fellowship and the National Health Journalism Fellowship. She is a graduate of Yale University.

CTMirror Contributor

SEE WHAT READERS SAID

RELATED STORIES
Can independent primary care doctors survive dominance of hospital health systems?
by Peggy McCarthy | C-HIT.ORG

hospital systems and private businesses are increasingly buying private medical practices and taking over their business operations.

Nearly three quarters of eligible CT residents expected to be vaccinated by end of April
by Jenna Carlesso

Since Thursday, 50,000 residents age 16 to 44 – the newest group granted access – received a first dose of the vaccine.

With demand for community health workers rising, so does need for sustainable funding
by Cara Rosner | C-HIT.ORG

New Haven Community Health Worker (CHW) Katia Astudillo helps dozens of her clients navigate the logistics of getting vaccinated and connects them with other health services. She even helps them find rental assistance. In and around New London, CHW Lizbeth Polo-Smith hands out flyers about COVID-19 safety and vaccinations at churches, laundromats, stores, warming centers […]

The vaccine effect: COVID cases jump, not hospitalizations or fatalities
by Mark Pazniokas

Officials credit Connecticut’s success in vaccinating older residents for keeping the COVID-19 death rate low as cases rise.

More than 1,800 people could get vaccinated at home under new DPH program
by Dave Altimari and Jenna Carlesso

Residents who wish to receive a vaccine at home must assert they are physically unable to get to a clinic.

Support Our Work

Show your love for great stories and outstanding journalism.

$
Select One
  • Monthly
  • Yearly
  • Once
Artpoint painter
CT ViewpointsCT Artpoints
Opinion A healthcare system too broken to fix
by Sosena Kedebe MD

On March 25, the White house announced that it was going to invest over $6 billion in health centers that are funded through the Resources and Services Administration (HRSA) in order to expand COVID-19 vaccinations and other health services provided to vulnerable populations. As a chief medical officer for a health center that is strained to reach some of the most disenfranchised patient population in Hartford, this was great news. Yet there was a part of me that took the news with a deep concern. Why you might ask?

Opinion The Connecticut Juvenile Training School and the lie that built it
by Colleen Shaddox 

Sitting in the paddy wagon, I was afraid – maybe apprehensive was a better word, since I rightly suspected that white privilege would guarantee me good treatment.  Still, I said a prayer of thanksgiving. After years of advocating for people in our carceral system, I was given a chance to develop more empathy.

Opinion Data on race, ethnicity and language is critical to making real healthcare progress
by Vicki Veltri, Tekisha Everette and Matt McDermott.

There are significant disparities in health status based upon race, ethnicity, and other factors that deprive many Connecticut residents of an equal opportunity to enjoy good health and well-being. That some Connecticut residents live without proper treatment of illness and injury due to disparities in health care access, affordability, and outcomes based upon race, ethnicity, and language (REL) is self-evident to many but not to all.

Opinion SB 1018: Connecticut’s effort to increase prosecutorial accountability and why it will not work
by Olivia Louthen

Senate Bill 1018 does not solve Connecticut’s largest criminal justice problem: outcomes for crime victims and defendants vary based on zip codes because judicial districts operate independently of one another.

Artwork Grand guidance
by Anne:Gogh

In a world of systemic oppression aimed towards those of darker skintones – representation matters. We are more than our equity elusive environments, more than numbers in a prison and much more than victims of societal dispositions. This piece depicts a melanated young man draped in a cape ascending high above multiple forms of oppression. […]

Artwork Shea
by Anthony Valentine

Shea is a story about race and social inequalities that plague America. It is a narrative that prompts the question, “Do you know what it’s like to wake up in new skin?”

Artwork The Declaration of Human Rights
by Andres Chaparro

Through my artwork I strive to create an example of ideas that reflect my desire to raise social consciousness, and cultural awareness. Jazz music is the catalyst to all my work, and plays a major influence in each piece of work.”

Artwork ‘A thing of beauty. Destroy it forever’
by Richard DiCarlo | Derby

During times like these it’s often fun to revisit something familiar and approach things with a different slant. I have been taking some Pop culture and Art masterpieces and applying the vintage 1960’s and 70’s classic figures (Fisher Price, little people) to the make an amusing pieces. Here is my homage to Fisher -Price, Yellow […]

Twitter Feed
A Twitter List by CTMirror

Engage

  • Reflections Tickets & Sponsorships
  • Events
  • Donate
  • Newsletter Sign-Up
  • Submit to Viewpoints
  • Submit to ArtPoints
  • Economic Indicator Dashboard
  • Speaking Engagements
  • Commenting Guidelines
  • Legal Notices
  • Contact Us

About

  • About CT Mirror
  • Announcements
  • Board
  • Staff
  • Sponsors and Funders
  • Donors
  • Friends of CT Mirror
  • History
  • Financial
  • Policies
  • Strategic Plan

Opportunity

  • Advertising and Sponsorship
  • Speaking Engagements
  • Use of Photography
  • Work for Us

Go Deeper

  • Steady Habits Podcast
  • Economic Indicator Dashboard
  • Five Things

The Connecticut News Project, Inc. 1049 Asylum Avenue, Hartford, CT 06105. Phone: 860-218-6380

© Copyright 2021, The Connecticut News Project. All Rights Reserved. Website by Web Publisher PRO