States Aim to Rein in Outpatient Facility Fees

States have been pursuing reforms that would limit hospitals’ ability to charge facility fees for routine medical services delivered in outpatient settings, which drove up enrollees’ premiums and out-of-pocket health care costs, according to a study by Georgetown University’s Center on Health Insurance Reforms.

Facility fees are charges from hospitals and other institutional health care providers that ostensibly cover their operational expenses for providing care. When hospitals acquire or affiliate with physician practices and other outpatient health care providers — a trend seen in the U.S. in recent years — ambulatory services provided at outpatient practices often generate a second bill for the facility fee on top of the professional fees the practitioners charge.