Legislation banning so-called “facility fees” at Colorado hospitals and clinics purports to be looking out for the consumer — but in fact would undermine our state’s health care providers and backfire on patients.
House Bill 23-1215 was amended in a House committee last Friday following an outcry from providers. However, the changes don’t come close to fixing what’s wrong with the measure. That explains why every major hospital system is opposed to HB 1215.
Lawmakers of both parties should oppose this bill if they value the critical care Colorado’s hospitals and clinics provide to all of the public, including our most vulnerable citizens.
Facility fees typically are those fees on a medical bill for outpatient care that fund a hospital’s or other provider’s core functions. In other words, all the things that provide treatment other than the physicians themselves. It means nurses, x-ray and lab techs, reception staff, security and maintenance personnel, behavioral health services, social workers — the list goes on.
Even as amended, HB 1215 still would ban facility fees for preventive care services, telehealth and primary care — a wide range of basic medical care on which many Coloradans depend. That stops hospitals and hospital-based primary care clinics and telehealth services from being reimbursed for their nurses, certified nursing assistants, registration staff, behavioral health counselors, social workers, housekeeping staff and more. That, in turn, will blow up on patients statewide. It will force some clinics to close outright and cut off patients’ access to care.
A spokesman for the nonprofit UCHealth system told us there are key telehealth services, for example, that are wholly reliant on facility fees for their operation. Virtual behavioral health services for veterans and others; nurses who are lactation experts; pharmacists who consult virtually with patients — that’s just a smattering — are all dependent on UCHealth charging facility fees.
UCHealth also offers primary care to the public through its A.F. Williams Clinic. The clinic treats patients using behavioral health experts, social workers and case managers, as well as nurses and certified nurse assistants. All must be paid for.
What was the inspiration for HB 1215? Supporters say they want to curb “surprise billing” for facility fees, which sometimes are rejected by insurers, leaving patients with the tab. Backers also claim the bill will advance hospital transparency.
Yet, UCHealth and all the state’s other hospital systems already support greater transparency efforts and can point to strides they have made in that regard. It’s not HB 1215’s transparency provisions that have drawn their opposition, of course; it’s the bill’s attempt to cut off the providers’ lifeblood. Certainly, lawmakers shouldn’t try to address billing disputes with insurers by monkey-wrenching health care providers’ ability to pay for themselves.
As noted in coverage last week by our news affiliate Colorado Politics, HB 1215 is based on a model bill proposed by the National Academy for State Health Policy, which according to the watchdog website InfluenceWatch is a “left-of-center” organization funded by the liberal Arnold Ventures fund. So far, only Connecticut and New York have banned facility fees. Colorado policymakers shouldn't wreak havoc with basic medical services simply to serve a narrow ideological agenda from the political fringe.
Whatever presumed problems HB 1215’s backers aim to solve, going after providers is a misfire. Rather than championing consumers, the bill slams the door on countless patients by cutting off essential health care services. Let’s hope that’s not this legislature’s idea of health care reform.
The gazette editorial board
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