HOUSE DOCKET, NO. 196        FILED ON: 1/14/2021

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1261

The Commonwealth of Massachusetts

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PRESENTED BY:

William J. Driscoll, Jr.

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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act providing financial transparency for patients receiving care at hospital-based outpatient facilities.

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PETITION OF:

HOUSE DOCKET, NO. 196        FILED ON: 1/14/2021

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1261

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-Second General Court
(2021-2022)

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An Act providing financial transparency for patients receiving care at hospital-based outpatient facilities.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

SECTION 1. Chapter 111 of the General Laws, as appearing in the 2018 Official Edition, is hereby amended by inserting the following:

Section 228A. (a) As used in this section, the following words shall, unless the context clearly requires otherwise, have the following meanings:

“Facility fee”, a fee charged or billed for outpatient hospital services provided in a hospital-based facility that is intended to cover the cost of the hospital operational expenses; which is separate and distinct from a professional fee.

“Hospital-based facility”, a provider of health care services, including but not limited to a department of a provider, a remote location of a hospital, or a satellite facility that meets the requirements of 42 C.F.R. § 413.65.

(a) Prior to the delivery of non-emergency services, a hospital-based facility that charges or bills a facility fee for services shall inform the patient that: 1) it is licensed as part of the hospital and the patient may receive a separate charge that is in addition to and separate from the professional fee charged by the provider; 2) the patient may incur financial liability that is greater than the patient would incur if the professional medical services were not provided by a hospital-based facility; and 3) information on how the patient can obtain financial liability for the known services through the hospital or the patient’s insurance carrier, along with information that the actual liability may change depending on the actual services provided. This information shall be provided in written form before the delivery of services.

(b) If a hospital or health system designates a location as a hospital-based facility, the facility shall clearly identify the facility as being hospital-based, including by stating the name of the hospital or health system in the facility’s signage, marketing materials, Internet web sites and stationery and by posting notices in designated locations accessible to and visible by patients in a manner proscribed by the commissioner.

(c) The commissioner may promulgate regulations that are necessary to implement this section.