14 recent state legislative actions supporting site-neutral payments

As calls continue for expanded use of site-neutral payment policies, many states have recently enacted legislation aiming to protect consumers from unknown or high facility fees from
providers, according to a July 21 analysis from the National Conference of State Legislatures.

Hospitals often use facility fees to cover inpatient and emergency care expenses, but they've increasingly appeared in outpatient settings such as hospital-owned physician offices and ASCs. Site-neutral payment policies aim to require the same price for every service, regardless of the setting where it was provided.

According to the NCSL, several states have recently passed laws that support site-neutral payment policies in some form.

14 legislative updates around facility fees:

  • Connecticut, Colorado, Maryland and New York passed legislation to require providers to give patients a written notice about a facility fee before services are provided, including a notification requirement for any new fees that occur after affiliation with a health system. 

  • Florida passed legislation requiring freestanding emergency departments to post signs in their entrances and waiting areas that disclose average facility fees. 

  • Indiana passed legislation requiring hospitals to report facility fee revenues in annual financial filings to the state. 

  • Colorado established a committee to study how facility fees affect patients, employers and payers, along with analyzing overall trends.

  • Connecticut expanded its list of specific outpatient services that providers cannot facility fees for. 

  • Colorado and New York prohibit facility fees for preventive services. 

  • Texas has banned facility fees for services provided at a drive-thru healthcare facility.

  • Connecticut, Ohio and Washington are limiting facility fees for telehealth visits. Connecticut and Ohio's laws apply to all telehealth visits, while Washington has banned facility fees for audio-only communications with providers.  


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