RELEASE: New report shows state pathways to end health care billing abuses stemming from consolidation

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WASHINGTON – Health care consolidation is leading to more expensive bills for patients, in part because of added facility fees — extra charges that patients usually have to pay out-of-pocket that help big health care companies bump up their profits. U.S. PIRG Education Fund’s new report, Outpatient outrage: Hospitals charge fees for care at the doctor’s office, released Tuesday, dives into why more patients are seeing facility fees on their medical bills. The report calls on states to ban these fees and take intermediary steps to protect patients by collecting data and ensuring patients know about these potential charges before getting care.

“Prices should reflect the cost of care, but too often our medical bills include more charges than services we got in the doctor’s office,” says Maribeth Guarino, health care advocate for the U.S. PIRG Education Fund. “Facility fees are intentional, additional fees that don’t reflect any direct services rendered. These seemingly random charges can confuse patients and increase their uncertainty about medical costs.”

Facility fees cost anywhere between a few dollars and thousands of dollars, and are arbitrary. They can stem from a change in facility ownership rather than any change to medical care. In Connecticut, the state with the best data on the issue, total facility fee revenue in 2021 was more than $400 million dollars — around $400 per patient visit.

While some federal proposals address facility fees, so far, only state legislatures have taken concrete steps to curb this issue. Fifteen states have passed some form of legislation to restrict facility fees, collect data or educate patients about these fees. Still, more needs to be done to protect patients and fix these billing practices.

This map shows the 15 states that have passed facility fee laws as of March 2024.

“Patients should only pay for the care they get,” Guarino said. “Bills should be transparent and sensible. We need to put an end to extraneous charges that have no relation to patients’ care or treatment.”