Senate health committee favorably reports substitute to change facility-fee rules, keep telehealth exception

The Senate Committee on Health & Human Services on Wednesday adopted a committee substitute for Senate Bill 1232 that rewrites how providers may charge facility fees and advances the measure out of committee on a 6-1 vote.

The substitute removes a requirement for national provider identification numbers, requires a study on facility fees using the all-payer claims database, eliminates a blanket ban on facility fees for preventive services, and creates an exception allowing facility fees for telehealth encounters when the patient is physically located at the facility, Senator Hancock said.

The changes, Hancock said, also expand the definition of "facility fee" to include certain insurance-owned facilities and "equity facilities," add a 90-day notice requirement to patients before a facility or health plan changes facility-fee practices, and align patient-notice protections with current state and federal guidelines. "It eliminates all national provider identification requirements," Hancock said while explaining the substitute.

Senator Hancock moved adoption of the committee substitute and then moved that Senate Bill 1232 "do not pass, but the substitute adopted in lieu thereof do pass and be printed," and the committee adopted the motion. The committee report was favorably issued by a 6-1 tally; Senator Miles recorded the lone no vote.

Committee debate recorded in the meeting was limited to the sponsor's explanation; Hancock also said the substitute was intended to be neutral and noted "there's still a couple of nonprofits that are opposed to a bill that doesn't do much," characterizing remaining external opposition. The transcript does not record additional floor debate or extended questioning by members on the record.

What the substitute would do in practice: it removes the previously proposed national provider identification requirement; directs a study of facility fees to be performed through the all-payer claims database; removes a categorical ban on charging facility fees for preventive services; establishes an exception for telehealth-based facility fees when the patient is physically located at the facility (described in the substitute as intended to preserve certain rural delivery mechanisms); broadens the statutory definition of facility fee to capture insurance-owned facilities and entities described as equity facilities; and requires a 90-day notice to patients per health plan before changes in facility-fee practices, aligning notice protections with existing state and federal guidance.

The committee's favorable report advances the substitute to the next legislative stage. No effective date, fiscal impact numbers, or additional statutory citations were given on the record during the committee meeting.