Lawmakers heard Tuesday from consumer advocates who support a bill to regulate so-called facility fees that are sometimes added to hospital bills without warning or explanation.

The fees pay for overhead costs at health care facilities and can add hundred of dollars to bills for routine outpatient services.

The bill, L.D. 2271, would require that hospitals and other health care facilities put up signs to notify patients that the fees may be charged, and would ban such fees for telehealth appointments. The Health Coverage, Insurance and Financial Services Committee held a public hearing on the bill Tuesday.

Kate Ende, policy director for Maine advocacy group Consumers for Affordable Health Care, said patients have complained about facility fees. Patients receiving routine care, such as a diagnostic test, may not be aware that the fees may be charged if they receive care at a hospital. Transparency would help the patients avoid such costs, she said.

“People do not expect to receive facility fees for routine care,” Ende said. A few states regulate facility fees, including Washington, Connecticut, Georgia, Maryland and Minnesota.

No one formally registered to testify against the bill, although advocates representing hospitals and health care providers pushed for minor changes. Maine law already prohibits charging facility fees in certain cases, such as when commercially-insured patients are receiving care in an office setting.


“We believe this bill is unnecessary. It is in search of a problem that doesn’t exist,” said Lugene Inzana, chief financial officer for Maine Medical Center Portland and associate chief financial officer for MaineHealth, the parent company of Maine Med.

But a survey by Consumers for Affordable Health Care this winter found that 27% of more than 500 registered voters said they had been charged a facility fee, and 62% said the fees were “excessive.”

Insurance industry officials, including Anthem Blue Cross Blue Shield and the Maine Association of Health Plans, testified in favor of the bill, arguing that greater transparency will help patients understand their medical bills and avoid unnecessary charges.

Ende said the ban on facility fees for telehealth appointments would “ensure patients aren’t charged fees when they are not actually using the facility.”

Jeff Austin, vice president of government affairs for the Maine Hospital Association, said he wasn’t aware of anyone in Maine ever being charged a facility fee for a (at-home) telehealth visit.

Austin, while testifying neither for nor against the bill, said facility fees are misunderstood and are part of the cost of delivering care.


“They do not drive up costs,” Austin said.

Press Herald investigation revealed that the fees are sometimes added to medical bills with no warning or explanation. And insurance companies sometimes refuse to cover them, leaving patients on the hook for hundreds of dollars in unexpected fees simply because they went to a hospital instead of seeking treatment elsewhere.

After the story was published, Senate President Troy Jackson, D-Allagash, introduced a bill to regulate the fees. The bill was amended to form a task force to study the topic. The task force’s recommendations, published in January 2024, formed the basis for the new bill.

James Myall, policy analyst for the Maine Center for Economic Policy, a left-leaning think tank, said that the bill is “a good first step.”

“Price transparency can be a foundation for a better health care system for all of us,” Myall said.

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