State of Washington
67th Legislature
2022 Regular Session
ByRepresentatives Macri, Cody, Simmons, Valdez, and Harris-Talley
Prefiled 01/07/22.Read first time 01/10/22.Referred to Committee on Appropriations.
AN ACT Relating to facility fees charged by certain health care providers; and amending RCW 70.01.040.
Sec. 1. RCW 70.01.040 and 2021 c 162 s 4 are each amended to read as follows:
(1) A health care provider may not charge, bill, or collect a facility fee except for services provided to a patient when the patient is on a hospital's campus.
(2) Prior to the delivery of nonemergency services, a provider-based clinic that charges a facility fee shall provide a notice to any patient that the clinic is licensed as part of the hospital and the patient may receive a separate charge or billing for the facility component, which may result in a higher out-of-pocket expense.
(((2)))(3) Each ((health care facility))provider-based clinic that charges a facility fee must post prominently in locations easily accessible to and visible by patients, including its website, a statement that the provider-based clinic is licensed as part of the hospital and the patient may receive a separate charge or billing for the facility, which may result in a higher out-of-pocket expense.
(((3) Nothing in this section applies to laboratory services, imaging services, or other ancillary health services not provided by staff employed by the health care facility.))
(4) As part of the year-end financial reports submitted to the department of health pursuant to RCW 43.70.052, all hospitals with provider-based clinics that bill a separate facility fee shall report:
(a) The number of provider-based clinics owned or operated, in whole or in part, by the hospital that charge or bill a separate facility fee;
(b) The number of patient visits at each provider-based clinic for which a facility fee was charged or billed for the year;
(c) The medicaid, medicare, and commercial health plan revenue received by the hospital for the year by means of facility fees at each provider-based clinic; ((and))
(d) The range of allowable facility fees paid by ((public or private))medicaid, medicare, and commercial health plan payers at each provider-based clinic; and
(e) Any additional information that the department requires.
(5) The department may impose sanctions on a hospital in accordance with RCW 70.41.130 for failure to comply with the requirements of this section.
(6) The department may adopt rules to implement the provisions of this section.
(7) For the purposes of this section:
(a) "Campus" means:
(i) A hospital's main buildings; and
(ii) The physical area immediately adjacent to a hospital's main buildings and other areas and structures, including a provider-based clinic, that are not strictly contiguous to the main buildings, but are located within 250 yards of the main buildings.
(b) "Facility fee" means any separate charge or billing by a provider-based clinic in addition to a professional fee for physicians' services that is intended to cover building, electronic medical records systems, billing, and other administrative and operational expenses, regardless of the modality through which the health care services were provided.
(((b)))(c) "Health care provider" means an individual, entity, corporation, person, or organization, whether for profit or nonprofit, that furnishes, bills, or is paid for health care service delivery in the normal course of business, and includes, but is not limited to, health systems, hospitals, and provider-based clinics.
(d) "Provider-based clinic" means the site of ((an off-campus))a clinic or provider office that is owned or operated, in whole or in part, by a hospital licensed under chapter 70.41 RCW or a health system that operates one or more hospitals licensed under chapter 70.41 RCW, is licensed as part of the hospital, and is primarily engaged in providing diagnostic and therapeutic care including medical history, physical examinations, assessment of health status, and treatment monitoring. This does not include ((clinics exclusively designed for and providing laboratory, X-ray, testing, therapy, pharmacy, or educational services and does not include)) facilities designated as rural health clinics, critical access hospitals, or sole community hospitals.
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