Greedy hospitals slapping billions in surprise ‘facility fees’ on Americans are ‘part of a pattern’ warns top Senate Republican Bill Cassidy who is urging Biden to step up and implement law to ensure transparency

A top Republican senator is urging the Biden administration to take action following a damning report that US hospitals are making billions of dollars by charging unsuspecting patients so-called “facility fees” for routine checkups at outpatient clinics.

A new Wall Street Journal report explored the frustration experienced by everyday Americans who are unwittingly charged hundreds of extra dollars intended for hospital overhead costs.

According to the Journal, the costs are becoming unavoidable as hospitals continue a pattern of steady acquisitions of medical practices.

The charges significantly increase the cost of standard medical procedures, including mammograms, colonoscopies and heart exams, by hundreds of dollars.

The No Surprises Act, which took effect in January 2022, addresses some of the concerns about surprise fees, but the administration has done little to implement the law, a top Republican warns.

Sen. Bill Cassidy, R-La., the ranking member of the powerful Senate Health, Education, Labor and Pensions (HELP) Committee, blames Biden for failing to implement the law.

“Facility fees are part of a pattern of patients not knowing how much they will be charged prior to a service,” Cassidy told DailyMail.com this week.

Facility fees, which typically amount to charging an individual for the use of the room in which he/she meets his/her doctor, are used to offset the costs of running a hospital.

“Unfortunately, the Biden administration has still not implemented these important policies,” Senator Cassidy told DailyMail.com

“The No Surprises Act addresses this with a provision called the Advanced Explanation of Benefits. “With this information, the patient knows how much they will be charged before agreeing to the service,” he continued.

“Unfortunately, the Biden administration has still not implemented these important policies.”

Hospitals argue that facility fees, which typically amount to charging an individual for use of the room in which they meet with their doctor, are necessary to offset the costs of federal regulations.

Reimbursements for outpatient services help hospitals pay for services such as neonatal ICUs, the argument goes.

In Maine and Ohio, four out of five medical bills for heart tests now sent to each state’s largest insurer come with a facility fee tacked on.

After hospitals buy clinics and doctors, the fees appear on patients’ bills.

Hospitals categorize once-boutique clinics as extensions of their centralized operations, giving longtime patients the option of paying the high fee or finding a new provider.

The Journal report claims that many hospital systems now earn at least half of their revenue from patients who are not admitted.

These numbers add up in the context of how much hospitals have purchased in recent years. By one estimate, about 50 percent of physicians work for hospitals.

Some who study such cases say the fees are not justified. Medicare consultants said fees collected in 2021 allowed the government program to overpay by $6 billion for a range of services.

Some lawmakers in Congress have proposed limiting the benefits covered by Medicare.

The House of Representatives passed a bill in December that would prevent Medicare from paying hospital costs for chemotherapy and other drug infusions administered by doctors at clinics that are not on a hospital campus.

The move would save the federal insurer just under $4 billion over the next decade.

The No Surprises Act, which took effect in January 2022, addresses some of the concerns about surprise fees, but the administration has done little to implement the law, a top Republican warns.

After big hospitals buy clinics and doctors, fees start showing up on patients’ bills

Some states have taken matters into their own hands. In Indiana, clinics outside hospital campuses affiliated with the largest nonprofit health care systems cannot charge fees

The group representing the interests of major hospitals – the American Hospital Association – does not want Congress to limit reimbursements.

It argues that these types of restrictions would deprive hospitals of the revenue they need in a cutthroat financial market.

Some states have taken matters into their own hands. In Indiana, clinics outside hospital campuses affiliated with the largest nonprofit health care systems cannot charge fees.

Other states have banned costs associated with telehealth or preventive care visits.

Some require hospitals to notify patients of the charges before booking an appointment.

Starting in July, Colorado hospitals will be required to disclose reimbursement rates to potential patients.