The bill amends Title 23 of the General Laws by adding Chapter 17.31, titled "Preventing Unwarranted Facility Fees." It establishes definitions for key terms such as "campus," "off-site from a hospital campus," "facility fee," and "healthcare provider." The bill prohibits healthcare facilities, hospital-based facilities, healthcare providers, or health systems from billing, charging, collecting, or seeking compensation for a facility fee for services provided off-site from a hospital campus. It also stipulates that no institutional claim shall be submitted for reimbursement for services provided off-campus, and any claims for outpatient services must include the physical address where the services were furnished and a unique site identifier.
Additionally, the bill requires that off-campus locations of hospitals apply for, obtain, and use a unique National Provider Identifier (NPI) for all claims submitted for reimbursement or payment for healthcare services provided at the off-campus location starting January 1, 2027. This unique NPI must be distinct from the hospital's main campus NPI and must be included on all claims for payment. The legislation aims to enhance transparency and accountability regarding charges associated with off-campus healthcare services, ensuring that consumers are protected from unwarranted facility fees. The act will take effect upon passage.