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8 months ago
22
A top Republican senator is urging the Biden administration to take action following a scathing report that American hospitals are making billions of dollars by charging unsuspecting patients so-called 'facility fees' for routine check ups in outpatient centers.
A new Wall Street Journal report examined the frustration afflicting everyday Americans who are unwittingly being billed hundreds of extra dollars that will go toward a hospital's overhead costs.
The fees are becoming unavoidable, according to the Journal, as hospitals continue a pattern of steady acquisitions of medical practices.
The fees significantly inflate the cost of standard medical procedures, including mammograms, colonoscopies and heart exams by hundreds of dollars.
The No Surprises Act, that went into effect in January 2022, addresses some of the surprise fee concerns, but the administration has done little to implement the law, warns one top Republican.
Sen. Bill Cassidy, R-La., the ranking member of the powerful Senate Health, Education, Labor and Pensions (HELP) Committee, is blaming Biden for failing to implement the law.
'Facility fees are part of a pattern where patients don't know how much they are going to be charged in advance of a service,' Cassidy told DailyMail.com this week.
A new Wall Street Journal report examines the frustration afflicting everyday Americans who are unwittingly being billed hundreds of extra dollars in 'facility fees'
Facility fees, which generally amount to essentially charging an individual for use of the room in which they meet with their medical practitioner, are used to offset the cost of running a hospital
'Unfortunately, the Biden administration still has not implemented this important policy,' Sen. Cassidy told DailyMail.com
'The No Surprises Act addresses this with a provision called the Advanced Explanation of Benefits. With this information, the patient knows how much they will be charged before agreeing to the service,' he continued.
'Unfortunately, the Biden administration still has not implemented this important policy.'
Hospitals claim the facility fees, which generally amount to essentially charging an individual for use of the room in which they meet with their medical practitioner, are necessary to offset the cost of federal regulations.
Outpatient service facility fees help hospitals afford services such as neonatal ICUs, so the argument goes.
In Maine and Ohio, four out of five medical bills for heart screenings that are now sent to each state's largest insurer has a facility fee tacked on.
After hospitals purchase clinics and doctors, the fees begin to show up on patients' bills.
Hospitals categorize the once boutique clinics as extensions of their centralized operations, leaving longtime patients with the option to pay the hefty fee or find a new provider.
The Journal report claims that many hospital systems are now earning at least half of their revenue from patients who have not been admitted.
Those numbers add up in the context of how much buying hospitals have done in recent years. One estimate suggests that some 50 percent of doctors work for hospitals.
According to some who study such matters, the fees are not justified. Medicare advisers said that the fees collected in 2021 allowed the government program to overpay by $6billion for a slate of services.
Some lawmakers in Congress have proposed limiting the fees covered by Medicare.
The House of Representatives passed a bill in December that would prevent Medicare from paying hospital fees for chemo and other drug infusions delivered by doctors in clinics not on a hospital campus.
The move would save the federal insurer just under $4billion in the next decade.
The No Surprises Act, that went into effect in January 2022, addresses some of the surprise fee concerns, but the administration has done little to implement the law, warns one top Republican
After major hospitals purchase clinics and doctors, the fees begin to show up on patients' bills
Some states have taken matters into their own hands. In Indiana, clinics located off hospital campuses affiliated with the largest nonprofit health systems, cannot charge fees
The group representing the interest of major hospitals - The American Hospital Association - does not want Congress to limit fees.
It argues that those sorts of restrictions would deprive hospitals of revenue they need in an unforgiving financial market.
Some states have taken matters into their own hands. In Indiana, clinics located off hospital campuses affiliated with the largest nonprofit health systems, cannot charge fees.
Other states have banned the fees attached to telehealth or preventative care visits.
Some require hospitals to notify patients about the fees before an appointment is booked.
Starting in July, hospitals in Colorado will have to disclose the fees to potential patients.
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