07 October 2009

Health care "facility fees"

[W]hen Kathy Young, 54, received a $25.59 bill for a "facility fee" separate from the $207 physician's charge for a recent routine eye exam, she called her health plan for an explanation. Young was told the fee was a "room charge" -- an item she might not have noticed previously...

...patients increasingly are being charged the fees, the result of an obscure change in Medicare rules that occurred nearly a decade ago. Called "provider-based billing," it allows hospitals that own physician practices and outpatient clinics that meet certain federal requirements to bill separately for the facility as well as for physician services...

Hospital executives say revenue from these fees is necessary to help defray their overhead... Critics vehemently disagree. They regard the fees as disguised price increases that ratchet up the cost of care... It is common for facility fees to be applied to an insurance plan's hospital deductible, which can be thousands of dollars higher than a physician deductible...

"We need to stop playing these kinds of games..."

Full story at the Washington Post.

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