USA Today on Thursday examined how some medical clinics are "considered 'hospital-based' and charge additional fees for the same services, even if they aren't inside an actual hospital." The practice is "legal and common but little known to patients," according to USA Today. The article profiles Virginia Mason Medical Clinic in Seattle, which was sued after charging facility fees without informing patients of the extra cost. The clinic settled the suit and agreed to better inform patients about the additional fees. According to USA Today, the settlements "come as the hospital industry is under increasing pressure to release more information about prices and is facing market pressure from private physicians who offer similar outpatient services in their offices or ambulatory surgery centers." Hospitals say the extra fees are necessary to offset costly services, including health care for uninsured patients, and to cover the additional administrative costs of running a clinic associated with a hospital. Lisa Brandenburg of the University of Washington, which has five hospital-based clinics, said, "We run between a 1% and 4% margin for the hospital, so, overall, we're really just covering the cost. If you want to look at facility fees in the global sense, how do we simplify how we pay for health care and yet still support folks like us that are part of the safety net." Attorney Matt Geyman of Seattle's Phillips Law Group, which represented patients who sued Virginia Mason, said, "When consumers are making decisions about where to go for health care, the court in this case is saying they have a right to know about these price differences." Facility fees are allowable under Medicare rules, but the recent court cases might gain the practice new scrutiny, USA Today reports (Appleby, USA Today, 11/16).

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