Prohibits hospitals, health systems, and health care providers from charging facility fees that are not covered by the patient's health insurance carrier.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A5342A
SPONSOR: Bores TITLE OF BILL:
An act to amend the public health law, in relation to prohibiting hospi-
tals, health systems, and health care providers from charging facility
fees that are not covered by insurance
PURPOSE OR GENERAL IDEA OF BILL:
To prohibit the billing or seeking of payment of facility fees
SUMMARY OF PROVISIONS:
Section one: short title
Section two: amends the Public Health Law to prohibit the billing of
facility fees
Section three: provides for the effective date
JUSTIFICATION:
This bill seeks to outlaw the practice of hospitals and healthcare
systems charging patients "facility fees" that are not covered by insur-
ance. Facility fees are particularly burdensome to patients, as they can
significantly increase the overall cost of care, often without providing
clear or justifiable benefits to the patient. This practice dispropor-
tionately impacts those without insurance, those with high-deductible
plans, and those already facing financial hardship, adding unnecessary
financial strain to accessing needed care. By limiting facility fees,
this bill aims to reduce the financial burden on patients and ensure
that the cost of medical services is more transparent and fair.
Facility fees, which are frequently added without proper disclosure or
explanation, have been criticized for their ambiguity and contribution
to rising healthcare costs, which remain a concern for both individuals
and the healthcare system as a whole. By banning these fees unless
covered by insurance, this bill encourages healthcare providers to focus
on transparent pricing that aligns more directly with the medical
services provided to the patient. This shift would promote more ethical
billing practices and help restore trust between patients and healthcare
providers, ensuring that patients are not blindsided by additional,
unexplained charges.
PRIOR LEGISLATIVE HISTORY:
None.
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
To be determined.
EFFECTIVE DATE:
This act shall take effect immediately.
STATE OF NEW YORK
________________________________________________________________________
5342--A
2025-2026 Regular Sessions
IN ASSEMBLY
February 13, 2025
___________
Introduced by M. of A. BORES -- read once and referred to the Committee
on Health -- committee discharged, bill amended, ordered reprinted as
amended and recommitted to said committee
AN ACT to amend the public health law, in relation to prohibiting hospi-
tals, health systems, and health care providers from charging facility
fees that are not covered by insurance
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. This act shall be known and may be cited as the "lower
2 hospital bills act".
3 § 2. Section 2830 of the public health law, as added by chapter 764 of
4 the laws of 2022, is amended to read as follows:
5 § 2830. Regulation of the billing of facility fees. 1. For the
6 purposes of this section, "fee" means any amount charged or billed by a
7 provider for professional health care services provided in a hospital-
8 based facility.
9 2. No hospital or health system or health care provider shall bill or
10 seek payment from a patient for a facility fee that is not covered by
11 the patient's health insurance carrier [unless the patient was notified
12 prior to the date of service that a facility fee would be applicable. If
13 a health care provider enters into a business relationship with a hospi-
14 tal or health system that will result in the provider's patients being
15 subject to facility fees, the health care provider must notify its
16 patients of the change and that facility fees will now be applicable to
17 services received from the health care provider. The notice shall be
18 provided in writing at least seven days in advance of each date of
19 service and shall explain the amount of the fee, the purpose of the fee,
20 whether the patient's insurance plan will pay the fee, and for uninsured
21 patients, how to apply for financial assistance. If advance written
22 notice is infeasible because the visit was secured less than seven days
23 in advance, then a written notice shall be provided on the date the
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD07961-02-5
A. 5342--A 2
1 service is rendered. The notice shall be provided in plain language in
2 conspicuous twelve-point bold face type and shall be available in the
3 top six languages spoken in the hospital's service area. In no event
4 shall a facility fee be charged for services related to the provision of
5 preventive care service as defined by the United States Preventive
6 Services Task Force].
7 § 3. This act shall take effect immediately.
