DENVER (KDVR) — Despite fierce opposition from the state’s network of hospitals, Colorado’s House Health and Insurance Committee passed a bill on an 8-3 vote to limit facility fees.
House Bill 1215 would make facility fees more transparent by mandating notification to patients at the time of service. In addition, the bill would ban facility fees for primary care, preventative care and telehealth visits. In a nod to opponents, the newly amended bill would also require a third-party report to study the impact of facility fees on hospitals and consumers.
The aim is to provide data to fact-check discrepancies in claims from hospitals on when, why, and how facility fees are charged
The bill is sponsored by Rep. Emily Sirota (D-Denver), Rep. Andrew Boesenecker (D-Fort Collins), Sen. Kyle Mullica (D-Thorton), and Sen. Lisa Cutter (D-Littleton) and follows numerous reports by the Problem Solvers in the past year about questionable medical bills.
Facility fees are charges imposed on patients that are increasingly levied by large hospital systems that own freestanding clinics and providers.
“Patients all across Colorado are getting hit with unexpected fees up to and sometimes over a thousand dollars with no clear explanation and no recourse after they’ve already paid for medical services, and these fees often aren’t covered by insurance,” Sirota said.
“House Bill 1215 will make hospital billing more transparent and save Coloradans money on health care. Thank you to my colleagues in the House for supporting this critical bill,” Sirota said.
“These unexplained charges are a major barrier to affordable health care that can drain a family’s bank account, and Coloradans are being forced to pay these fees more and more often as large hospital systems merge and buy up clinics across our state,” Boesenecker said.
“By passing House Bill 1215, we are standing up for patients by demanding lower costs and more transparency,” Boesenecker said.
Opposition to bill limiting, banning facility fees
But critics of the measure, said facility fees are needed to keep hospitals afloat and help pay for all the staff and infrastructure at both hospitals and off-site clinics.
“If they were to go away their institutions would be underwater,” John Reilly, dean of the Colorado School of Medicine, said.
He was one of a dozen health care providers to testify against the measure, which would exempt Denver Health and some 30 mostly rural hospitals, that serve a large percentage of the uninsured.
Julie Lonborg with the Colorado Hospital Association told the Problem Solvers the measure could cost hospitals across the state billions in revenue and could put the viability of some clinics at risk.
“This has the potential to have devastating catastrophic consequences to the patient care system in Colorado,” Lonborg said.
Families affected by facility fees
But patients and consumer advocates increasingly felt blindsided and gouged by facility fee bills they had no idea they were on the hook for until they received a bill after the fact.
“I was recently sent a facility fee bill for $847 that was not covered by my health insurance after I had already paid hundreds of dollars for my son’s doctor’s visit,” Brittany Tesso of Castle Rock said.
“Not only that, but the fee was for a telehealth visit for which I never even set foot near a facility. Limiting facility fees for telehealth visits is just common sense. House Bill 1215 will make this system more transparent, affordable, and fair for families like mine who already struggle with the high cost of health care,” Tesso said.
“My family was totally shocked to receive a facility fee for over $2,500 that we were expected to pay out-of-pocket after taking our son to see a specialist for his seizures, even though the provider we visited was in-network,” Ben Los of Colorado Springs said.
“House Bill 1215 can bring transparency to facility fees so families like mine aren’t blindsided by $2,500 in hospital charges,” Los said.
Experts who testified in support of House Bill 1215 say facility fees have increased as more independent physician practices have been bought up by hospitals and private equity firms, who then impose facility fees that were not charged by private doctor practices.
The share of primary care physicians in Colorado working for a practice owned by a hospital or health system grew from about 20% in 2009 to nearly 50% by 2019, according to a Brookings Institute analysis of survey data collected from physician practices.
The facility fee measure will now move on to the appropriations committee.