Facility Fees for Virtual Visits; Board Slow to Investigate Nurses; Eyeing Opioid $$

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Facility Fees for Virtual Visits

As more Americans are blindsided by "facility fees" for telehealth appointments, states are starting to intervene in order to limit bills for services provided beyond the walls of a healthcare facility, according to Kaiser Health News.

Hospital executives argue facility fees are needed to pay for staff and other overhead expenses to maintain the hospital, regardless of the fact a patient does not physically enter the facility. But state lawmakers around the country, including in Connecticut and Colorado, are taking stands against the fees.

Colorado state representative Emily Sirota (D), who sponsored a bill to limit these fees in the state, told KHN that facility fees "are simply another way that hospital CEOs are lining their pockets at the expense of patients."

Hospital consolidation has been a catalyst behind increased billing in general, KHN reported, giving them more power to negotiate higher fees with health plans, which can then be passed on to patients.

States working to limit facility fees are implementing measures such as prohibiting add-on fees for telehealth, requiring payment for Medicaid services to be "site-neutral," and collecting more data on these fees.

Hospital executives believe these measures would negatively impact health systems that attempt to offer telehealth services, which could force clinics to close and cause some patients to lose access to care, KHN reported.

Board Slow to Investigate Nurses

The Minnesota Board of Nursing has been slow to investigate complaints against nurses, potentially putting the public at risk, according to an investigation by ProPublica.

Investigations into allegations of misconduct by nurses have dragged on for months, and in some cases years, according to the report. While the speed of investigations temporarily improved after a 2015 state audit, cases are now backing up once again, ProPublica reported.

Since 2018, the average time to resolve a complaint against a nurse has more than doubled to 11 months, and hundreds of complaints have been left open for more than a year, according to the article.

This failure to quickly address complaints has allowed some nurses to continue practicing and potentially jeopardize patients' health, the report argued. Delays in handling investigations have become a key point of contention among staffers and board members, with blame being placed on COVID-19 protocols, a high rate of turnover on the board, and the management style of a new executive director.

Tracking Opioid Settlement Money

More than $50 billion in opioid settlement funds is starting to flow to state and local governments, but there's not much transparency around how the money will be spent, according to Kaiser Health News.

Reporting requirements are few and far between, documents that have been filed tend to be vague, and defining exactly how the money can be spent is subject to interpretation, KHN reported.

Most settlements mandate that at least 85% of the money must be spent on addiction treatment and prevention, but this stipulation is open to interpretation by those responsible for the funds and by state politics, the article stated.

People who've lost loved ones to opioid overdoses are left wondering whether the money will be used to address the root causes of the epidemic. Many people whose lives were deeply affected by the opioid crisis are "again feeling traumatized" as they are left in the dark and even treated as nuisances by officials responsible for managing these settlement funds, KHN reported.

The only oversight for how the money is spent has been left to the companies making payouts, which are unlikely to spend the time and resources to be vigilant, the article stated. In addition, only 12 states have committed to publicly reporting their use of the funds, and few states have pledged to report the spending in publicly accessible ways.

Christine Minhee founded OpioidSettlementTracker.com and worked with KHN on this investigation.

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