Facility fees charged to patients covered by the state employee and retiree health plan will get increased scrutiny under a proposal expected to pass the General Assembly.
The measure is included in this year’s budget implementer, a lengthy proposal that includes the policy provisions needed to enact the state budget as well as a host of other changes.
Facility fees are charges patients can face if they seek care at medical facilities owned by hospitals. They’re in addition to fees for health care providers’ services and can amount to hundreds or thousands of dollars. Hospitals say the fees reflect higher standards and costs associated with hospital-based medical practices, but state officials, including Healthcare Advocate Victoria Veltri and Attorney General George Jepsen, have questioned their value. Both have received many complaints from patients who said they were surprised to receive bills for facility fees.
The House voted unanimously this year for a bill that would require patients to receive notices about any facility fees they might face. (It hasn’t yet come up in the Senate.)
The implementer addresses facility fees in a different way. It calls for the state comptroller to analyze the effect facility fees have on the state employee and retiree health plan, and to determine whether the fees are appropriate and reasonable. Among other things, the comptroller is to take into account the size of the fees and whether they’re associated with improved service and patient outcomes. The bill also requires the comptroller to determine the feasibility of no longer reimbursing health care providers for facility fees that have been deemed inappropriate or unreasonable. The analysis must be submitted to the governor, legislators and the labor-management committees that oversee that health plan by Oct. 1, 2015.