Prohibits hospitals, health systems, and health care providers from charging facility fees that are not covered by the patient's health insurance carrier.
Summary
Bill A05342, known as the "lower hospital bills act," seeks to amend the public health law by prohibiting hospitals, health systems, and healthcare providers from charging facility fees that are not covered by a patient's health insurance. The bill mandates that if a facility fee is applicable, patients must be notified in writing at least seven days prior to the date of service, detailing the fee, its purpose, and insurance coverage. In cases where the appointment is made less than seven days in advance, notice must be provided on the date of service. Additionally, the bill ensures that no facility fees can be charged for preventive care services as defined by the United States Preventive Services Task Force.
Impact
If enacted, this bill would significantly alter the billing practices of hospitals and healthcare providers in New York, ensuring that patients are not unexpectedly charged for facility fees that their insurance does not cover. This change aims to enhance transparency in healthcare billing and protect patients from surprise medical bills, particularly for services that are preventive in nature. The bill could also lead to a reevaluation of how facility fees are structured and communicated within the healthcare system.
Sentiment
The sentiment surrounding Bill A05342 appears to be generally supportive, particularly among patient advocacy groups and individuals concerned about healthcare costs. However, there may be some opposition from healthcare providers and hospitals who may view the regulation as an additional burden on their billing practices and revenue streams. The discussions indicate a recognition of the need for clearer communication regarding facility fees, but also a concern about the potential financial implications for healthcare institutions.
Contention
Notable points of contention include the potential financial impact on hospitals and healthcare providers who rely on facility fees as a revenue source. Some stakeholders argue that the requirement for advance notice could complicate billing processes and lead to increased administrative costs. Conversely, advocates for the bill emphasize the importance of protecting patients from unexpected charges and ensuring they have access to clear information about their healthcare costs. The debate reflects a broader tension between patient rights and the financial realities of healthcare providers.
Same As
Prohibits hospitals, health systems, and health care providers from charging facility fees that are not covered by the patient's health insurance carrier.
Prohibits hospitals, health systems, and health care providers from charging facility fees that are not covered by the patient's health insurance carrier.
Provides that no facility fee shall be charged for services when a hospital-based facility is a distant site for health care services delivered by telehealth unless the service is provided by a health care provider not authorized to bill a professional fee separately for the service.
Provides that no facility fee shall be charged for services when a hospital-based facility is a distant site for health care services delivered by telehealth unless the service is provided by a health care provider not authorized to bill a professional fee separately for the service.
Mandates all health insurance contracts, plans, or policies provide the same reimbursement to independent healthcare facilities as that of hospital affiliated facilities where the same healthcare service is provided.
Mandates all health insurance contracts, plans, or policies provide the same reimbursement to independent healthcare facilities as that of hospital affiliated facilities where the same healthcare service is provided.
An Act Establishing That The Violation Of Any Provision Prohibiting The Collection Of A Facility Fee By A Hospital, Health System Or Hospital-based Facility For Certain Outpatient Health Care Services Is An Unfair Trade Practice.