Gov. Kim Reynolds urged nonprofit University of Iowa Health Care to eliminate higher hospital rates billed to patients for cancer care after it purchased Mission Cancer + Blood in late 2024.
Reynolds also said in a July 16 letter to UI Health’s CEO she hoped the Iowa Legislature would join at least nine other states and Congress in restricting or regulating the facility fees.
“This concerns me — not only because of why it’s happening, but because of where it’s happening,” she wrote in a letter to Bradley Haws, chief executive officer of UI Health Care. “UIHC has long been recognized as a public institution with a mission to serve the people of Iowa. That mission should include making high-quality cancer care as accessible and affordable as possible — not increasing fees simply because services can now be billed under a hospital affiliation.”
Reynolds letter followed a Reader’s Watchdog column July 14 showing thousands of patients are being charged more for cancer care following the shift in ownership from a for-profit independent practice with 20 clinics around the state to UI Health ownership. Billing changes began last June.
Two employees confirmed to the Register that patients had been angered by the billing changes, which caused people to pay hundreds, sometimes thousands, more out of pocket. Numerous patients also complained on social media.
The spike in bills comes as more Americans are having difficulty affording cancer care and more Iowans are in need of it. Reynolds’ husband Kevin was diagnosed with lung cancer in 2023.
In a July 17 letter responding to Reynolds and released to the Register, Haws contended Mission’s billing practices were “not discretionary pricing decisions.”
“They are the result of federally established billing regulations that govern hospital-based outpatient departments across the nation. As an integrated hospital health system, UI Health Care, along with Unity Point and MercyOne, are required to bill these services under the applicable federal framework,” he wrote.
He said revenue generated through UI Health’s cancer programs are directly reinvested into advancing cancer care for Iowans.
“These investments support clinical research, access to innovative therapies and clinical trials, recruitment and retention of highly specialized oncology providers, expansion of cancer screening and prevention programs, and comprehensive survivorship services that help patients navigate life during and after cancer treatment,” he wrote.
In Washington, policymakers have expanded Medicare “site-neutral” payment policies so hospital outpatient departments pay the same rates as physician offices for some more common services. In November last year, for example, CMS finalized a policy to align Medicare payments for certain drugs administered in physician offices and hospital outpatient departments.
Nine states — Connecticut, Indiana, Maine, Maryland, Mississippi, New York, Ohio, Texas and Washington — have prohibited providers from charging outpatient facility fees for specified procedures and/or care settings, according to the Center on Health Insurance Reforms at Georgetown University.
Increasingly, Americans cannot afford the growing cost of care.
In a Federal Reserve Board annual economic well-being survey 26% of adults said they skipped medical expenses in 2025 because of the cost. Almost 40% of Americans cannot afford an unexpected $400 medical expense without selling assets or borrowing money.
“I respectfully urge UIHC to eliminate the unnecessary practice of charging hospital facility fees at Mission Cancer clinics, and to prioritize policies that reduce — not increase — the financial burden on cancer patients and their families,” Reynolds said in her letter. “Transparency in billing and a commitment to affordable care are essential to maintaining the public’s trust in a public institution.”
The governor noted Iowa ranks second in the nation for cancer incidence, and that many Iowans seek care at Mission Cancer for its “outstanding reputation and providers.”
“While I understand that acquisitions and organizational changes can affect billing practices, choosing to increase the burden placed on patients should not be treated as an acceptable consequence,” the governor wrote.
Reader’s Watchdog seeks information on cancer costs
Did you recently receive a higher-than-expected bill for cancer care, cancer medication or cancer prevention care? If so, the Register’s Watchdog columnist, Lee Rood, would like to talk to you and review that information. You can reach her at lrood@dmreg.com.
Lee Rood’s Reader’s Watchdog column helps Iowans get answers and accountability from public officials, the justice system, businesses and nonprofits. Reach her at lrood@registermedia.com, at 515-284-8549, on Twitter at @leerood or on Facebook at Facebook.com/readerswatchdog.
Lee Rood’s Reader’s Watchdog column helps Iowans get answers and accountability from public officials, the justice system, businesses and nonprofits. Reach her at lrood@registermedia.com, at 515-284-8549, on X at @leerood or on Facebook at Facebook.com/readerswatchdog.
This article originally appeared on Des Moines Register: Reynolds urges UI to end higher bills at Mission Cancer | Exclusive
Reporting by Lee Rood, Des Moines Register / Des Moines Register
USA TODAY Network via Reuters Connect
By Lee Rood, Des Moines Register | USA TODAY Network
