A new report from the Arizona PIRG Education Fund finds that Arizonans are getting hit with what are known as facility fees, leading to higher costs for medical care.

Maribeth Guarino, health-care advocate with PIRG, said facility fees can be thought of as a flat charge, added to a patient's bill only for stepping through the door of a doctor's office to seek care. She said facility fees are arbitrary and cost anywhere between a few dollars and thousands of dollars.

"We're seeing them more because hospitals are buying up independent clinics, physician's offices and other independent provider care settings and then charging these fees as though they're hospital locations, even though nothing has changed except the logo and the letterhead," she explained.

According to Guarino, 15 states around the country, including Florida and Texas, have laws on the books relating to facility fees, but Arizona isn't one of them. She noted states could better prioritize patient protections by ensuring they're informed about the fee before receiving care. And while several federal proposals have been introduced to address the issue, none has made it to the president's desk.

Guarino said the Federal Trade Commission has issued a rule to prohibit what she terms "junk" fees, and hopes the Federal Trade Commission will apply that rule to items such as facility fees. And for patients, she recommends reviewing your bill after you have received care.

"And do your best to shop around, if you can, before you get services," she advised, "because even though there aren't always laws in place to protect patients, sometimes you'll be surprised how much information is out there if you just ask directly."

Guarino added there is no guarantee you'll get that answer, but it doesn't hurt to ask. She said patients should only pay for the services they receive, and providers need to be transparent about the fees they charge.

The state of Washington has launched an online system for tracking food poisoning cases.

The Washington State Health Department has opened its Foodborne Illness Notification System for filing complaints about food safety. Bill Marler, a food-safety lawyer in the state, said the system will rely on data to pinpoint potential food-safety hazards.

"If you get more and more people utilizing these services," he said, "just the sheer volume of the data will make it more useful because you get more angles to look at."

The Health Department says the system is anticipated to help with early detection of diseases, illness prevention, proactive safety measures and educational opportunities. The state has noted that one in six Americans suffers from food poisoning each year.

Marler said he believes the data collection will be helpful, but also notes that it isn't a panacea for stopping outbreaks. He said listeria is a good example: the period between consumption and onset of illness is between three and 70 days.

"I'm not sure I can remember what I ate three days ago, let alone what I ate 70 days ago," said Marler. "So, a lot of this analysis is sometimes flawed by people's memories and the incubation periods."

Marler added that listeria is also a pressing example because of the outbreak of it in deli meat. According to the Centers for Disease Control and Prevention, two people have died and 28 have been hospitalized from the current outbreak across the country, although no cases have been reported in Washington state.


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Big changes are imminent in the way homes are bought and sold, as the new forms for transactions in California come out today.

The forms are linked to the proposed legal settlement by the National Association of Realtors, which ends the long-standing practice of having a home seller's agent pay a commission to the buyer's agent. It benefited buyers who may not have saved up enough money to pay their agent.

George Lopez, a real estate agent in Indian Wells, explained buyers will now have to negotiate a separate contract to hire and pay their own agent.

"Even with these changes, a buyer can still purchase a home without having the money to pay their agent," Lopez explained. "The general public needs to understand that the real estate commissions have been, and will always be, negotiable - and that if they don't have money to pay their agent, they can still potentially negotiate it in their sale."

The lawsuit contended the old way of selling homes tended to drive up costs, as buyers' agents had more incentive to steer people to sellers willing to pay a higher commission. The changes are intended to empower homebuyers to negotiate for a better deal.

Lopez thinks most sellers will still offer to pay a real estate broker, rather than risk losing out on a big chunk of the prospective buyer pool. But it will have to be negotiated in the offer, as commissions will no longer be stated in the Multiple Listing Service. The changes also mean buyers' agents cannot just meet prospective clients "on the fly" anymore, to go check out a home for sale.

"You have to meet me at the office; we have to have a meeting," Lopez pointed out. "We have to have an agreement in place that said that you're hiring me, or I can't show you any homes."

The new forms real estate agents use to complete transactions will take effect nationwide on Aug. 17.


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A new Virginia law protects residents from utility shutoffs in extreme weather.

The law prevents utility company shutoffs when temperatures are at or below 32 degrees and at or above 92 degrees. It also prevents shutoffs during states of emergency in response to public health emergencies. Virginia was one of 34 states with a shutoff moratorium during the pandemic.

Kajsa Foskey, economic justice outreach coordinator for the Virginia Poverty Law Center, said enacting this law cleared up some misconceptions.

"Most folks already thought that utilities couldn't shut them off on a day when it was too hot or too cold outside," she said. "So, what we've really done is just created some common-sense foundational protection so that all utility customers across the state know what their rights are."

Despite having some of these shutoff guidelines as unwritten rules, utility companies pushed back, saying it didn't allow them flexibility. Foskey said she thinks the state can build on this by including elements that didn't become law. This includes requiring data collection from utilities about who is being shut off, the frequency, reasons, and the amounts owed. She said this can help craft solutions for people facing shutoffs.

Rising utility prices concern advocates since this increases shutoffs. More than 750,000 Virginia families are energy cost-burdened, meaning they spend 6% of their income on utility bills.

Foskey said another removed part of the law would have reduced financial barriers to reconnection.

"When they try to get reconnected," she said, "not only do they have to pay that past-due amount that they couldn't afford to pay, they now also have to pay reconnection fees, late fees, security deposits, things that really just make the barrier to getting reconnected very high."

She added that this can prevent people from being able to afford everyday essentials such as food or rent. However, the new law has a provision for customers who received state energy assistance in the past year. They're eligible for having their deposit capped at 25% of what they previously owed to be reconnected, but this can only be used once every three years.