Colorado bill limiting hospital facility fees gets toned down over provider objections

By Par Ferrier, Fort Collins Coloradoan

Published: Mar. 23, 2023

Sponsors of Colorado House Bill 1215 that would have limited or banned the fees hospitals can charge for certain care are trimming back the bill after hearing from providers and hospitals.

The original bill, co-sponsored by Fort Collins Democratic Rep. Andrew Boesenecker, would have prohibited hospitals from charging facility fees for telehealth visits, most outpatient visits or services that occur in their off-campus clinics such as Poudre Valley Hospital’s Harmony Cancer Center or Medical Center of the Rockies’ outpatient infusion clinic.

Facility fees pay for clinic staff including nurses, nurses’ aides, billing clerks, receptionists, security personnel, IT specialists, housekeepers and other staff, but not the doctor. Depending on patients’ insurance plans, the facility fee can range from nothing to several thousand dollars. Patients who haven’t met their deductibles may have to pay a larger piece of the fee.

Sponsors of Colorado House Bill 1215 that would have limited or banned the fees hospitals can charge for certain care are trimming back the bill after hearing from providers and hospitals.

The Colorado Hospital Association and health systems such as UCHealth said House Bill 1215 would be catastrophic to their operations. The hospital association estimated it would cost them about $9 billion in revenue and lead to the closure of some small, rural hospitals.

While the original bill would have banned most facility fees, the newly structured bill focuses more narrowly on gathering data about facility fees and increasing transparency for consumers, but it still bans facility fees for telehealth, preventive services that are often already fully covered by insurance, and primary care, according to a summary released by Health Care Without Hidden Costs, a coalition of dozens of organizations and individuals focused on making health care more transparent and affordable.

Prohibiting facility fees for primary care services and for telehealth would still cause significant problems throughout the state, forcing some clinics to close and causing patients to lose access to the care they need, said Dan Weaver, spokesperson for UCHealth.

Weaver cited nurse lactation experts who provide lactation consultations; behavioral health services delivered to veterans and other patients; pharmacists who consult on patients’ medications; and nurses who offer care or advice through telehealth visits. The facility fee is the only reimbursement they receive for those visits, he said.

“Importantly, we have a broad team of staff members and IT experts who support the critical infrastructure for telehealth,” Weaver said. “Telehealth also is critically important for more rural areas of our state, connecting those patients with specialists who otherwise would not be available. Patients in our state need more telehealth and primary care services, not less.”

While hospitals claimed there would be catastrophic losses in funding, patient care and clinic locations under the initial bill, they have not provided evidence of that, according to Health Care Without Hidden Costs.

Third-party data is central to fact-checking discrepancies in claims from hospital systems on when, why and how facility fees are charged and where that funding is going, a spokesperson for Health Care Without Hidden Costs said.

But Weaver said “it is dangerous and irresponsible to push such sweeping policy when, by the proponents’ own admission, they don’t understand the impacts. And yet, in these new proposed amendments, they are pushing ahead to ban facility fees in primary care and telehealth clinics.”

Isabel Cruz, Colorado Consumer Health Initiative’s policy director, said in a statement they’ve been “working with hospitals to address concerns since before the bill was introduced in February. With the proposed changes, we have emphasized consumer protections and included provisions that are common sense. Why should a patient get a bill for a service they thought they could count on to be free?”

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Colorado bill limiting hospital facility fees gets toned down over provider objections

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