N.Y. Public Health Law 2830*2 – Regulation of the billing of facility fees
* § 2830. Regulation of the billing of facility fees. 1. For the purposes of this section, "fee" means any amount charged or billed by a provider for professional health care services provided in a hospital-based facility.
Terms Used In N.Y. Public Health Law 2830*2
- Facility fee: means any fee charged or billed by a hospital or by a health care professional authorized under title eight of the education law that is: (a) intended to compensate the hospital or health care professional for the operational expenses regardless of the modality through which the health care services are provided; and (b) separate and distinct from a professional fee. See N.Y. Public Health Law 2801
- Health system: means a group of one or more hospitals and providers affiliated through ownership, governance, membership or other means. See N.Y. Public Health Law 2801
- Hospital: means a facility or institution engaged principally in providing services by or under the supervision of a physician or, in the case of a dental clinic or dental dispensary, of a dentist, or, in the case of a midwifery birth center, of a midwife, for the prevention, diagnosis or treatment of human disease, pain, injury, deformity or physical condition, including, but not limited to, a general hospital, public health center, diagnostic center, treatment center, a rural emergency hospital under 42 USC 1395x(kkk), or successor provisions, dental clinic, dental dispensary, rehabilitation center other than a facility used solely for vocational rehabilitation, nursing home, tuberculosis hospital, chronic disease hospital, maternity hospital, midwifery birth center, lying-in-asylum, out-patient department, out-patient lodge, dispensary and a laboratory or central service facility serving one or more such institutions, but the term hospital shall not include an institution, sanitarium or other facility engaged principally in providing services for the prevention, diagnosis or treatment of mental disability and which is subject to the powers of visitation, examination, inspection and investigation of the department of mental hygiene except for those distinct parts of such a facility which provide hospital service. See N.Y. Public Health Law 2801
- Provider: means an individual or entity, whether for profit or nonprofit, whose primary purpose is to provide professional health care services. See N.Y. Public Health Law 2801
2. No hospital or health system or health care provider shall bill or seek payment from a patient for a facility fee that is not covered by the patient's health insurance carrier unless the patient was notified prior to the date of service that a facility fee would be applicable. If a health care provider enters into a business relationship with a hospital or health system that will result in the provider's patients being subject to facility fees, the health care provider must notify its patients of the change and that facility fees will now be applicable to services received from the health care provider. The notice shall be provided in writing at least seven days in advance of each date of service and shall explain the amount of the fee, the purpose of the fee, whether the patient's insurance plan will pay the fee, and for uninsured patients, how to apply for financial assistance. If advance written notice is infeasible because the visit was secured less than seven days in advance, then a written notice shall be provided on the date the service is rendered. The notice shall be provided in plain language in conspicuous twelve-point bold face type and shall be available in the top six languages spoken in the hospital's service area. In no event shall a facility fee be charged for services related to the provision of preventive care service as defined by the United States Preventive Services Task Force.
* NB There are 2 § 2830's