Hospitals Charging Facility Fees for Preventive Services
By Consumers for Quality Care, on February 14, 2024
Although preventive procedures are covered under the Affordable Care Act (ACA), hospitals are charging consumers “facility fees” for these services, according to KFF Health News.
Kristy Uddin, 49, an occupational therapist, is more familiar than most with the complexities of the health care system. She believed that her annual mammogram would be fully covered under the ACA. When she received a bill for $236, she contacted her insurer and asked for an independent review. She found out that the cost was not incurred for the mammogram itself, but rather for the equipment used at the hospital where she had the procedure. “This is not how the law is supposed to work,” said Uddin.
While the ACA has been a major benefit to consumers and provided many new protections that did not exist before 2010, stories like Uddin’s have become increasingly more common in recent years. Hospitals are now adding “facility fees” to bills, even for preventive care that should be fully covered. Further complicating these types of issues is the lack of enforcement from agencies to regulate anti-consumer billing abuses. One of the most disturbing aspects of these hidden fees is that they tend to force consumers to skip or delay seeking preventive care, hurting their longer-term health outcomes.
CQC urges providers to put an end to absurd facility fees and lawmakers to combat these predatory practices. In addition, CQC calls Congress to strengthen the ACA and to ensure that preventive care services remain fully covered as originally intended.
