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House of Representatives
Session of 2017 - 2018 Regular Session


Posted: July 21, 2017 09:43 AM
From: Representative Dan Frankel
To: All House members
Subject: Banning Outpatient Facility Fees
In the near future, I will introduce legislation to ban most outpatient facility fees for common medical procedures and services.

Outpatient facility fees have grown exponentially in recent years as hospitals continue a trend of acquiring doctors’ offices, designating them as “outpatient departments” and then charging patients an add-on fee for certain services provided. These fees are often several times the cost of the doctor’s visit or procedure itself and are usually the responsibility of the patient to pay, not the insurance company.

Since I first offered facility fee legislation several Sessions ago, many states have passed laws to address this issue. In Connecticut, Republicans and Democrats worked together to pass legislation that required disclosure of all outpatient facility fees and banned any facility fee charged for an “evaluation and maintenance” (E&M) procedure or service. E&M refers to procedures or services received during a regular doctor’s visit and often include consultations, preventive medicine, and other general outpatient services.

My legislation follows the Connecticut model by banning outpatient facility fees for E&M-coded procedures. While facility fees would still be permissible for non-E&M procedures such as surgery and anesthesia, my legislation would require that those fees be disclosed to patients ahead of time.

According to the Pennsylvania Insurance Commissioner, there have been numerous consumer complaints of surprise outpatient facility fees across the state, with the average fee adding $230 to a patient’s bill. It is time that we make a concerted, bi-partisan effort to protect our constituents from these fees, and I hope you will join me in support of this important legislation.