Maine lawmakers this session approved a bill requiring hospitals and other health care facilities to clearly inform patients that they charge facility fees. It’s a watered-down version of a bill to regulate when and how the often costly fees to defray operational costs are being imposed.

The House and Senate both approved the bill, L.D. 2271, on voice votes with no roll call taken.

The bill now goes to Gov. Janet Mills, who hasn’t yet taken a position on the latest version of the bill.

Ann Woloson, executive director of Consumers for Affordable Health Care, a nonprofit that supports regulation of facility fees, said the bill, while far less strict than earlier proposals, is still a win for patients, who sometimes get charged hundred of dollars in facility fees.

“We see this as a positive first step,” Woloson said. “We hear a lot of confusion from Mainers about facility fees, why and when they are charged, how much they will be charged and how to decipher such fees on hospital bills.”

The bill would require health care facilities to post signs in their buildings and on their websites that facility fees are being charged, but it does not require that hospitals or other health care settings disclose the specific amounts of the fees. The amount a patient pays can vary, depending on their insurance coverage.

Woloson said that requiring any additional information to be provided to patients is a good step toward greater transparency.

Consumers for Affordable Health Care surveyed Mainers about facility fees this year and found that 27% said they had been charged such fees and 62% said they were excessive.

“We are hopeful that policymakers will take additional steps that help minimize the burden such fees have on patients,” Woloson said.

Lawmakers removed from the bill a provision that would have barred patients who receive services through telehealth – without visiting a health care facility – from getting charged a facility fee.

Hospital officials advocated to remove stronger regulations from the bill, arguing that facility fees sometimes are necessary because of the large amount of overhead that it costs to run a hospital.

A Press Herald investigation revealed that hospitals sometimes hide the fees in medical bills with no 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 from another provider.

After the stories were published, Senate President Troy Jackson, D-Allagash, introduced a bill to regulate the fees. The bill was amended to form a commission to study the topic, and the task force’s recommendations became the basis for L.D. 2271.

HOSPITALS PUSHED BACK

But as the bill went through the legislative process and hospitals lobbied, the regulations became weaker. For instance, one provision recommended by the task force that didn’t make it into the bill would have banned facility fees from being charged at hospital-affiliated facilities that weren’t located on the hospitals’ main campuses.

Jeff Austin, vice president of government affairs for the Maine Hospital Association, said during a hearing this winter that outright banning of facility fees in certain cases would “have a devastating financial impact on hospitals, including the potential closure of some facilities and the loss of patient access to health care services.”

And Lugene Inzana, associate chief financial officer of MaineHealth, in testimony before the Legislature’s Health Coverage, Insurance and Financial Services Committee in March, said that Maine already has a number of regulations on the books that require disclosure of facility fees or bans them in certain cases, such as in office settings for those covered by private insurance.

Katie Harris, chief government affairs officer for MaineHealth, said in a statement on Friday that “we appreciate that the (health coverage) committee ultimately concluded that Maine’s hospitals are not inappropriately charging patients. We understand that hospital billing can be complex, and at times patients can become frustrated with that complexity.”

But Stephanie DuBois, a spokesperson for Anthem Blue Cross Blue Shield, said on Friday that despite certain Maine limits, facility fees sometimes are being incorrectly put on patients’ bills. She said more needs to be done in future legislative sessions to improve protections for patients.

“It was encouraging to see progress,” DuBois said. “But we want to see strengthened protections for Mainers.”