There is an ongoing dispute between hospital and health plan leaders in North Carolina over the use of “facility fees” in outpatient billing, NC Newsline reported March 12.
Last year, the Senate passed a bill that would restrict facility fees to only being charged when patients are treated at hospitals, facilities with emergency departments or ASCs. Hospitals would no longer be able to add a facility fee to bills from a clinic or physician’s office under the proposal. But the bill has yet to move forward in the legislative process.
Peter Daniel, executive director of the N.C. The Association of Health Plans told legislators that the proposed legislation could cut healthcare costs by an estimated $200 million per year, according to the report. He noted that while facility fees were originally designed to support around-the-clock hospital operations, they’re being applied to hospital-owned physicians’ offices and clinics, which operate during normal business hours.
He also cited cases where facility fees are alleged to have “dramatically” increased medical bills, Newsline reported. In one case reported on in 2021 by The Charlotte Ledger, a man was charged a $5,300 facility fee for colonoscopy at a hospital-owned clinic.
Nine states have limits on facility fees charged to commercial health insurance, with specific restrictions varying state-by-state. Josh Dobson, CEO of North Carolina Healthcare Association, told the publication that facility fees go towards paying for staff, supplies and equipment at hospital-owned clinics, pushing back on the need for further restrictions.
Senator Jim Burgin, a Republican from Harnett, specifically questioned hospitals implementing facility fees after acquiring established physician practices. He noted that people pay these fees through their insurance premium or with tax dollars through government health insurance plans, but often with little to no change to the care received.
“I think that’s what’s frustrating to a lot of people,” he said, according to Newsline. “Nothing changes but the ownership.”
