Facility Fees Charged/Billed by a Hospital or Health System
What is the statutory authority for this new filing requirement and when is it due?
Effective October 1, 2015, C.G.S. §§ 19a-508(c) (k) and (m) require the filing of this information no later than July 1, 2016 and annually thereafter.
Section 4 of Public Act 21-129 made changes to the filing requirements of C.G.S. § 19a-508c on facility fees.
Section 31 of Public Act 22-81 made a change to Subsection (h) of C.G.S. § 19a-906 on facility fees for telehealth visits and states that no telehealth provider or hospital shall charge a facility fee for telehealth services. Such prohibition shall apply to hospital telehealth services whether provided on campus or otherwise.
What are Facility Fees for purposes of this submission?
C.G.S. §19a-508c (a)(3) defines “Facility fee” as any fee charged or billed by a hospital or health system for outpatient hospital services provided in a hospital-based facility that is:
(A) Intended to compensate the hospital or health system for the operational expenses of the hospital or health system, and
(B) separate and distinct from a professional fee
What is a Hospital-Based Facility?
C.G.S. §19a-508c(a)(6) defines a "Hospital-based facility" as a facility that is owned or operated, in whole or in part, by a hospital or health system where hospital or professional medical services are provided.
What is a hospital campus for purposes of this submission?
Only a facility located outside a hospital campus is included in this data submission. C.G.S. § 19a-508c (a)(2) defines a hospital campus as:
(A) 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 two hundred fifty yards of the main buildings, or
(B) any other area that has been determined on an individual case basis by the Centers for Medicare and Medicaid Services to be part of a hospital's campus
Again, this filing is for outpatient services for which a facility fee was charged and the location is not on a hospital campus using this definition.
What is a Tagline?
Public Act 21-129 defines a tagline as a short statement written in a non-English language that indicates the availability of language assistance services free of charge.
How should information be filed?
- Complete both Table 1 and Table 2 which can be found at this link using these instructions. (For a hospital system, the higher level system parent is the reporting entity and the contact person is an in-state representative of the system. Report on only business entities operating in Connecticut.)
- Upload the completed Tables 1 and 2 as both an Excel and PDF file.
- By October 1st, provide a copy of the written notice, with tag lines, that are in locations that are readily accessible to and visible by patients. (Submit as a PDF file.)
- By October 15th, provide a sample of a billing statement. The billing statement should not include any patient identifying information and should also include tag lines. (Submit as a PDF file.)
- Find the Facility Fee Billing Affidavit at this link. (All hospitals/health systems must complete this affidavit even if they do not charge/bill facility fees at any off-campus hospital-based facility.)
- Find the Facility Fee Notification Affidavit at this link. (Only hospitals/health systems that charge facility fees at any off campus hospital-based facility need to complete this affidavit.)
- All documents should be uploaded to the following portal https://ohsnotificationandfilings.ct.gov/Filing/Index.
- Find the Hospital Facility Fee Notice template that complies with C.G.S. § 19a-508c(k) at this link.
- Portal instructions for uploading all required information are at this link.
- Find Facility Fee submission Questions and Answers are at this link. Email any additional questions to OHS@ct.gov.
How to access Facility Fee Filings
To access facility fee information for reporting entities use the “Other Required Filings” and ‘Facility Fees” tabs at: