Colorado bill would ban hospital “facility fees” from certain medical bills, including for telemedicine care

A proposal in the Colorado legislature would ban “facility fees” from certain medical bills, a move the legislation’s sponsors say will save patients from unexpected costs while hospitals argue it would threaten access to health care.

When you get a medical bill, you’ll likely be charged a provider fee (for the doctor or physician associate’s time) and a facility fee, if the clinic where you got care is owned by a hospital. You could also be charged separately for any medications you received or supplies used to treat you.

House Bill 23-1215 would prohibit facility fees if the care is provided via telemedicine, or in a clinic that’s owned by a hospital but not located on its campus. It also would ban facility fees for procedures that can be performed safely somewhere other than a hospital.

The Colorado Medical Services Board would be required to define which services could safely be performed somewhere other than a hospital by the end of March 2024. They could conceivably include almost all imaging services, office visits and at least some minor surgeries.

Other provisions would:

• Require providers to notify patients when they could be charged facility fees

• Direct Colorado’s All Payer Claims Database, which aggregates information about what insurers pay for health care, to compile a report about facility fees

• Make it a “deceptive trade practice” to charge a facility fee when it’s been banned, which would allow the Colorado Attorney General’s Office to investigate

“We have heard from patients across Colorado who are getting bills with unexpected fees of over a thousand dollars with no explanation on top of what they pay through insurance,” Rep. Emily Sirota, a Denver Democrat and one of the bill’s sponsors, said in a news release. “Facility fees are simply another way that hospital CEOs are lining their pockets at the expense of patients, and we simply can’t let this continue.”

The other sponsors are Rep. Andrew Boesenecker, a Fort Collins Democrat; Sen. Kyle Mullica, a Thornton Democrat; and Sen. Lisa Cutter, a Littleton Democrat.