HOUSE HEALTH AND HUMAN SERVICES COMMITTEE SUBSTITUTE FOR

HOUSE BILL 306

57th legislature - STATE OF NEW MEXICO - second session, 2026

 

 

 

 

 

 

 

AN ACT

RELATING TO HEALTH CARE; PROHIBITING HEALTH CARE FACILITY FEES FROM BEING CHARGED FOR CERTAIN SERVICES; REQUIRING DISCLOSURE OF FACILITY FEES TO PATIENTS AND REPORTING OF FACILITY FEES TO THE ALL-PAYER CLAIMS DATABASE.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

     SECTION 1. [NEW MATERIAL] SHORT TITLE.--This act may be cited as the "Fair Pricing for Routine Medical Care Act".

     SECTION 2. [NEW MATERIAL] DEFINITIONS.--As used in the Fair Pricing for Routine Medical Care Act:

          A. "affiliated with" means that a person is:

                (1) employed by a hospital or health system; or

                (2) under a professional services agreement, faculty agreement or management agreement with a hospital or health system that permits the hospital or health system to bill on behalf of the person;

          B. "campus" means:

                (1) a hospital's main buildings;

                (2) the physical area immediately adjacent to

a hospital's main buildings;

                (3) structures owned by a hospital that are

not strictly contiguous to the main buildings but are located

within two hundred fifty yards of the main buildings; or

                (4) any other area that has been determined by the federal centers for medicare and medicaid services, on

an individual case-by-case basis, to be part of a hospital's campus;

          C. "facility fee" means a fee charged or billed by

a hospital or health system for outpatient hospital services that is:

                (1) intended to compensate the health system

or hospital for operational expenses; and

                (2) separate and distinct from a professional

fee charged or billed by a hospital or health system for professional medical services;

          D. "freestanding emergency department" means a facility licensed by the health care authority that is separate from an acute care hospital and that provides twenty-four-hour emergency care to patients at the same level of care that a hospital-based emergency department delivers;

          E. "health facility" means a health facility or health agency required to be licensed by the health care authority pursuant to the Health Care Code;

          F. "health system" means a:

                (1) parent corporation of one or more hospitals and any person affiliated with the parent corporation through ownership, governance, membership or other means; or

                (2) hospital and any person affiliated with the hospital through ownership, governance, membership or other means;

          G. "hospital" means a health facility that is licensed by the health care authority as a hospital;

          H. "preventive health care service" means a service recommended by the United States preventive services task force;

          I. "rural" means a rural county or an unincorporated area of a partially rural county, as designated by the health resources and services administration of the United States department of health and human services; and

          J. "telehealth" means the use of electronic information, imaging and communication technologies, including interactive audio, video, data communications and store-and- forward technologies, to provide and support health care delivery, diagnosis, consultation, treatment, transfer of medical data and education when distance separates the patient and the health care provider.

     SECTION 3. [NEW MATERIAL] LIMITATIONS ON CHARGES FOR CERTAIN HEALTH CARE SERVICES PROVIDED IN CERTAIN SETTINGS.--

          A. Except as provided in Subsection D of this section, beginning January 1, 2027, a hospital or health system shall not charge, bill or collect a facility fee directly from a patient for:

                (1) preventive health care services provided in an outpatient setting, including services accessed from the patient's vehicle;

                (2) vaccination services provided in an outpatient setting, including services accessed from the patient's vehicle; or

                (3) telehealth services.

          B. Nothing in this section prohibits a hospital or health system from charging a facility fee for:

                (1) health care services provided in an inpatient setting;

                (2) health care services provided at a hospital emergency department; or

                (3) health care services provided at a freestanding emergency department.

          C. Nothing in this section prohibits a hospital or health system from charging, billing or collecting a facility fee from a patient's insurer pursuant to an agreement between the hospital or health system and the insurer or as required by law.

          D. The provisions of Subsection A of this section shall not apply to a hospital or a hospital's clinic located in a rural area.

          E. Notwithstanding the provisions of Subsections B, C and D of this section, a hospital or health system shall not charge, bill or collect a facility fee directly from a patient who does not have health insurance coverage and is provided the benefits of a health care service for which a facility fee would otherwise be charged.

     SECTION 4. [NEW MATERIAL] BILLING TRANSPARENCY AND PATIENT NOTIFICATION.--

          A. Beginning January 1, 2027, a hospital or health system that charges a facility fee shall:

                (1) at the time an appointment is scheduled and again at the time health care services are rendered, provide notice to a patient that:

                     (a) discloses that a facility fee may be charged;

                     (b) indicates the amount of the facility fee;

                     (c) discloses that a facility fee may not be covered in whole or in part by the patient's insurance; and

                     (d) to the extent practicable, shall be provided in the patient's preferred language;

                (2) post a plainly visible sign written in English and Spanish that states that a patient may or may not be charged a facility fee in addition to the cost of a professional fee. The sign shall:

                     (a) include information on the types of facility fees that the hospital or health system is prohibited from charging under the Fair Pricing for Routine Medical Care Act;

                     (b) disclose that patients who do not have health insurance coverage are exempt from paying a facility fee under the Fair Pricing for Routine Medical Care Act;

                     (c) be located within the health facility in an area where patients seeking care register or check in; and

                     (d) include information on where a patient may inquire further about facility fees; and

                (3) provide patients with a standardized bill that:

                     (a) is clear, consumer-friendly and, to the extent practicable, in the patient's preferred language;

                     (b) includes itemized charges for each health care service provided;

                     (c) specifically identifies any facility fee charged;

                     (d) identifies specific charges that have been billed to the patient's insurance; and

                     (e) provides contact information for a person the patient may contact to contest charges in the bill.

          B. If a patient, after receiving notice pursuant to Paragraph (1) of Subsection A of this section and before services are rendered, declines, cancels or reschedules an appointment because the facility fee is too high or may not be covered by the patient’s insurance plan, the hospital or health system shall not impose a cancellation fee, no-show fee or other penalty for that appointment.

     SECTION 5. [NEW MATERIAL] FACILITY FEE REPORTING.--A hospital or health system that charges a facility fee shall report data related to the facility fee to the all-payer claims database established pursuant to the Health Information System Act. The data shall include the following information for services provided by a hospital in inpatient settings and outpatient settings and in locations on the hospital's campus and off the hospital's campus during each of the three previous calendar years:

          A. the number of times facility fees were charged to patients;

          B. the total dollar amount of facility fees charged to patients;

          C. the twenty-five most common billing codes for which a facility fee was charged and the total amount charged to patients for each of those codes;

          D. the twenty-five billing codes with the highest average patient charges and the total amount charged to patients for each billing code; and

          E. any other data required by the department of health to assess the prevalence and cost of facility fees in the state.                   - 8 -