Legislation would rein in unfair hospital facility fees

A woman from Mineola, Texas reached out to PIRG after she was charged more than double what she expected for her appointment with her oncologist. She had been told she would be responsible for a $180 copay, but the bill was for nearly $400. During the appointment, she had been sent to get a PET scan on a different floor of the same building. As she fought the bill, she learned that the floor the imaging machine was on was owned by a hospital. This led the hospital to charge her a $212 facility fee. She was told she had to pay the hospital facility fee despite her never stepping foot into the hospital itself. Situations like this, where patients are unfairly charged hospital fees in non-hospital settings, are happening all over Texas.

But the Texas legislature is considering a law to solve it. The legislation, SB 1232/HB 2556, would protect consumers against some unfair hospital “facility fees” – added charges originally intended to offset hospital expenses like 24 hour nursing and expensive medical equipment. But today, facility fees are commonly billed in non-hospital settings. These fees increase patients’ medical bills with no added service or improvement in the quality of care they receive. 

High medical costs are a significant concern to Texans: in 2024, 63% of Texas adults skipped or delayed some form of medical care due to costs. It’s time to stop this over-billing and protect Texans from facility fees for medical care in a non-hospital setting.

The Texas legislation follows the lead of several other states, banning facility fees for telehealth appointments. It would also require facilities to give 10-day advance notice of the amount of any facility fees they charge, ensuring patients aren’t caught off guard by these bills. 

TexPIRG has been working with the bill’s Senate sponsor to make sure they know the impact these facility fees have on consumers. Rachel Carnahan-Metzger, a hospital social worker and TexPIRG volunteer, spoke at a Senate Committee hearing in support of the bill. She shared the stories of two Texas patients who have been charged facility fees for regular doctor appointments. Rachel urged the committee to expand the bill to include a ban on facility fees for preventive care appointments, which are usually provided at no charge to insured people. PIRG asks supporters of the legislation to reach out to their representatives and ask them to vote for the bill.

If enacted, this legislation would mark an important first step in protecting Texans from the added cost of facility fees.