Plain English Breakdown
The official summary lists 'specified preventative health care services' without defining exactly which ones are included.
AB-225: Rules on Health Care Facility Fees
Starting January 1, 2028, this law stops hospitals and health systems from charging extra facility fees for certain outpatient visits like preventive care or telehealth.
What This Bill Does
- Prohibits providers, hospitals, or health systems from charging a facility fee for specific outpatient services starting on January 1, 2028.
- Requires providers to tell patients at scheduling and check-in if they will charge any allowed facility fees.
- Mandates that hospitals report the number of visits with facility fees and total amounts charged to state officials.
- Stops health insurance plans from paying for or covering prohibited facility fees in their contracts.
- Requires providers to pay back patients who already paid a fee that is now banned under this law.
Who It Names or Affects
- Health care providers, hospitals, and health systems
- Patients receiving outpatient services
- Health care service plans and health insurers
Terms To Know
- Facility fee
- An extra charge added to a medical bill for using the building or equipment, separate from the doctor's professional fee.
- Telehealth
- Medical care provided remotely through video calls or phone conversations instead of an in-person visit.
Limits and Unknowns
- The law does not ban the billing of professional fees for medical services.
- Specific details on which preventive health services are covered by this rule are listed elsewhere and not fully described here.
- The text states that no state reimbursement is required for local agencies, but it does not explain the specific reason why.