An Act to Protect Patients by Prohibiting Certain Medical Facility Fees
Maine Legislature, Session 131, LD 1795
Committee: Health Coverage, Insurance and Financial Services
Sponsors: JACKSON, TALBOT ROSS, BALDACCI, DAUGHTRY, HICKMAN, INGWERSEN, NANGLE, TIPPING, VITELLI
Amends: 22 MRSA §1718-H

Legislative Document
No. 1795
S.P. 720
In Senate, April 25, 2023
An Act to Protect Patients by Prohibiting Certain Medical Facility 
Fees
Reference to the Committee on Health Coverage, Insurance and Financial Services 
suggested and ordered printed.
DAREK M. GRANT
Secretary of the Senate
Presented by President JACKSON of Aroostook.
Cosponsored by Speaker TALBOT ROSS of Portland and
Senators: BALDACCI of Penobscot, DAUGHTRY of Cumberland, HICKMAN of Kennebec, 
INGWERSEN of York, NANGLE of Cumberland, TIPPING of Penobscot, VITELLI of 
Sagadahoc.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §1718-H is enacted to read:
§1718-H.  Hospital facility fees
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings.
A.  "Campus" means the main buildings of a hospital; the physical area immediately 
adjacent to a hospital's main buildings and other areas and structures that are not strictly 
contiguous to the main buildings but are located within 250 yards of the main buildings; 
and any other area that has been determined on a case-by-case basis by the federal 
Department of Health and Human Services, Centers for Medicare and Medicaid 
Services to be part of a hospital's campus.
B.  "Facility fee" means any fee charged or billed by a health care provider for 
outpatient services provided in a hospital-based facility or freestanding emergency 
facility that is intended to compensate the health care provider for the operational 
expenses of the health care provider, separate and distinct from a professional fee, and 
charged or billed regardless of how a health care service is provided.
C.  "Freestanding emergency facility" means an emergency medical care facility that 
is licensed under section 1811.  "Freestanding emergency facility" does not include an 
urgent care clinic.
D.  "Health care provider" means a person, whether for profit or nonprofit, that 
furnishes bills or is paid for health care service delivery in the normal course of 
business.  "Health care provider" includes, but is not limited to, a health system, 
hospital, hospital-based facility, freestanding emergency facility or urgent care clinic.
E.  "Health system" means:
(1)  A parent corporation of one or more hospitals;
(2) Any entity affiliated with the parent corporation through ownership, 
governance, membership or other means; or
(3) A hospital and any entity affiliated with the hospital through ownership, 
governance, membership or other means.
F.  "Hospital" means a hospital licensed under section 1811.
G.  "Hospital-based facility" means a facility that is owned or operated, in whole or in 
part, by a hospital where hospital or professional medical services are provided.
H.  "Professional fee" means any fee charged or billed by a health care provider for 
professional medical services provided in a hospital-based facility.
2.  Limits on facility fees.  This subsection governs limits on facility fees.
A.  A health care provider may not charge, bill or collect a facility fee, except for:
(1) Services provided on a campus;
(2) Services provided at a facility that includes a hospital's emergency department; 
or
(3) Emergency services provided at a freestanding emergency facility.
B. Notwithstanding paragraph A, a health care provider, regardless of the location of 
services, may not charge, bill or collect a facility fee for:
(1) Outpatient evaluation or management services; or
(2) Any other outpatient, diagnostic or imaging services identified by the 
department pursuant to subsection 3.
3.  Identification of services. The department shall annually identify services subject 
to the limitations on facility fees provided in subsection 2, paragraph B that may reliably 
be provided safely and effectively in settings other than hospitals.
4.  Annual report.  A hospital, health system and freestanding emergency facility shall 
submit a report annually to the department relating to facility fees charged or billed during 
the preceding calendar year. The department shall publish the information reported 
pursuant to this subsection on its publicly accessible website.  The report must be in a 
format as prescribed by the department and must include:
A. The name and full address of every facility owned or operated by the hospital, health 
system or freestanding emergency facility that provides services for which a facility 
fee is charged or billed;
B. The number of patient visits at a hospital-based facility or freestanding emergency 
facility for which a facility fee was charged or billed;
C. The number, total amount and range of allowable facility fees paid at a hospital-
based facility or freestanding emergency facility by Medicare, the MaineCare program 
or private health insurance;
D. For each hospital-based facility, hospital, health system or freestanding emergency 
facility, the total amount of facility fees charged or billed and the total revenue received 
from facility fees;
E.  The top 10 procedures or services, identified by procedural terminology codes used 
by the American Medical Association, provided by the hospital, health system or 
freestanding emergency facility that generated the greatest amount of gross revenue 
from facility fees, the number of patients charged or billed for each of the 10 procedures 
or services, the gross and net revenue totals for each procedure or service and the total 
net amount of revenue received that was derived from facility fees;
F.  The top 10 procedures or services, identified by procedural terminology codes used 
by the American Medical Association, provided by the hospital, health system or 
freestanding emergency facility overall for which facility fees are charged or billed 
based on the number of patients charged or billed for the 10 procedures or services, 
including the gross and net revenue totals received for each procedure or service; and
G.  Any other information related to facility fees required by the department.
5.  Rules.  The department may adopt rules necessary to implement this section, 
including, but not limited to, specifying the format and content of reports and imposing 
penalties for noncompliance consistent with the department's authority under this chapter.
6.  Enforcement.  This subsection governs enforcement of this section.
A.  A violation of this section is an unfair practice in the conduct of any trade or 
commerce pursuant to Title 5, section 207.
B. A health care provider that violates any provision of this section or any rules adopted 
pursuant to this section is subject to an administrative penalty of not more than $1,000 
per violation.
C.  The department or its designee may audit a health care provider for compliance 
with the requirements of this section. The department or its designee may request 
copies of any books, documents, records or data that are necessary for the purposes of 
completing the audit.  A health care provider shall make those records available and 
maintain records for 4 years after providing a service for which a facility fee was 
charged, billed or collected.
SUMMARY
This bill prohibits certain health care providers from charging, billing or collecting a 
facility fee in certain situations and requires annual reporting on the amount of facility fees 
charged or billed.