Extra Health-Care Facility Fees
Take Many Patients by Surprise
By Sandra G. Boodman
Kaiser Health News
Tuesday, October 6, 2009
But when 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.
Baffled, she reviewed two years of paperwork and found that the fee hadn't appeared until this year. "Why am I paying for it?" she asked. "And why wasn't I told when I made the appointment?"
Similar complaints are occurring more often, consumer advocates across the country say, because 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. Because hospitals that bill Medicare beneficiaries this way must do so for all other patients, facility fees affect patients of all ages. Doctors' offices owned by physicians and freestanding clinics are not permitted to charge them.
READ MORE:
http://www.washingtonpost.com/wp-dyn/co ... 02910.html
Take Many Patients by Surprise
By Sandra G. Boodman
Kaiser Health News
Tuesday, October 6, 2009
But when 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.
Baffled, she reviewed two years of paperwork and found that the fee hadn't appeared until this year. "Why am I paying for it?" she asked. "And why wasn't I told when I made the appointment?"
Similar complaints are occurring more often, consumer advocates across the country say, because 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. Because hospitals that bill Medicare beneficiaries this way must do so for all other patients, facility fees affect patients of all ages. Doctors' offices owned by physicians and freestanding clinics are not permitted to charge them.
READ MORE:
http://www.washingtonpost.com/wp-dyn/co ... 02910.html