Hospitals face increased scrutiny for charging facility fees

[mahatmakanejeeves]

Hospitals face increased scrutiny for charging facility fees

By Fred Schulte | Center for Public Integrity December 23, 2012

After Vermont hospitals started buying up local doctors’ practices, state Sen. Kevin Mullin of Rutland began hearing complaints that some patients were paying much more for routine care. ... One family accustomed to paying about $120 in out-of-pocket costs for doctor visits and other medical services was outraged when their costs for similar visits soared to $1,000, Mullin said.

The reason for the increase: The physician practice had been bought by a local hospital, and “all of a sudden everything was charged differently,” said Mullin, a Republican. ... The higher bills reflected “facility fees.” For years, hospitals that own physician practices and outpatient clinics have been allowed by Medicare to tack on these fees, separate from bills for doctors’ services, for the use of the facilities. As hospitals buy up medical practices and set up outpatient treatment centers, more of these fees are showing up on patients’ bills.
....

Connie Peterson, 67, a retired graphics designer in Iowa City, was aghast when an outpatient surgery center sent her a bill for nearly $26,000 in facility fees. ... “I was livid,” said Peterson, who spent months trying to get an explanation. “All I wanted was an itemized bill to let me know exactly what I’m paying for.”

Peterson had three procedures to remove nasal polyps during her 45-minute stay at the Iowa City Ambulatory Surgical Center in April. The center billed more than $8,000 in facility fees for each one, bringing the total to $25,872. She had to pay $1,086 of that, and her insurer negotiated a payment for the rest. The center said its rates were in accordance with national standards. Responding to criticism, hospitals are supporting a bill in Congress that would require more disclosure so that patients could compare prices. Some states already require that.
....

The Center for Public Integrity is a nonprofit, independent investigative news outlet. For more of its articles on this topic, visit http://www.publicintegrity.org/health/medicare/cracking-codes

[enlightenment]

1. And it won't stop.

As long as there is a profit motive - in insurance and in hospital care - prices will rise.

How on earth does a 45-minute procedure produce $8624 in "facility fees"? Everything, from anesthesia to the cotton ball they shoved up her nostril is already billed - so what is left? Room rental? The salary of the nurse? A charge for walking through the door? I would love to see them itemize these fees, just for the humor of reading such unbelievable fiction.

[dwilso40641]

2. What could go wrong?

Tax exempt churches own non-profit hospitals who own physician practices and out patient clinics.
Churches are not about religion any more. They are a business now and should be taxed as such.

[BrotherIvan]

3. A hospital I took my mother looked like a Las Vegas hotel

Giant chandeliers, a waterfall and a stream running through the middle of it. Perfectly manicured grounds. Who pays for that? You guessed it. Gambling built LV hotels, but sick & dying people built that hospital.

[Faryn Balyncd]

4. Call it what it is: systemic, INSTITUTIONALIZED fraud.

The most innovative & aggressive practitioner of aggressive billing is the person who created Columbia Hospitals in his own image, turned it into the largest hospital chain in the world, setting the world record for largest settlement for Medicare fraud ($1.7 billion - no typo), and is now governor of Florida.

Gangster "capitalism" has taken over medicine, and (not only Hippocrates and Sir William Osler, but) Adam Smith, who noted the necessary role of government in preventive abusive, monopolistic practices, would VOMIT.

[KT2000]

5. compare prices?

Not here. Our one and only hospital is buying up practices and charging facility fees for using the exam room for every doctor visit. They own the majority of medical practices already.
Good this woman's insurance covered some of the facility fee - mine did not. I canceled the recommended procedure because of the thousands I could be liable for.
Fraud.

[Doctor_J]

7. You shouldn't have to "shop around" for health care anyway

you're not buying a fucking used car.

I have about 10 years until Medicare and will be putting off most non-critical procedures until then. Hopefully if I do get sick, I'll die before my grandkids' entire inheritance is wiped out.

[Doctor_J]

6. we just had a colonoscopy at a hospital and got 6 bills

Last edited Sun Jul 6, 2014, 11:34 AM - Edit history (1)

Primary care doc, hospital, GI specialist, radiologist, pathologist, anesthetist. I am happy there aren't parking meters at the hospital.

then because a polyp was found, the procedure was declared "not routine" and went from "covered" ($30 copay) to "not so much" ($750). We may be able to spend a couple hours on the phone and get it re-classified though. So THAT one of the 6 different charges might turn out to be not so bad.

I am so glad that for-profit insurance is a part of our lives, forever.

[airplaneman]

8. I had my first facility fees experience.

Went to a clinic for a procedure and was told there would be a $81.50 copay. They had me sign something saying that I understand this was a copay that I had to pay before the procedure would be done. When the bill arrived was the first It was called a facility fee. I kind of feel the for profit machine is looking for other ways to extract more money. Today,s $81.50 facility fee will be tomorrows $595.00 facility fee I see it coming.
-Airplane