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.

Florida Power & Light's request for a nearly $9 billion rate hike, possibly the largest in state history, has sparked concern about the potential burden on people already struggling with high energy costs.

The Florida Public Service Commission is reviewing the proposal, which the utility said is needed for grid resilience, population growth and storm recovery. If approved, the hike would raise the average residential bill by at least $200 a year by 2027, in addition to a $150 "storm recovery fee" already on bills this year.

Maria Claudia Schubert-Fontes, climate justice program manager for the advocacy group Catalyst Miami, warned the effects on low-income households could be devastating.

"Energy burden is the percentage of income that's spent on home energy bills and also is considered 'energy burdened' if it's at 6%," Schubert-Fontes explained. "So, 12% is way above that threshold and folks are spending a large portion of their income just to keep the lights on every month."

Florida Power & Light, which serves about 12 million people, has said the increase is necessary to continue providing reliable service as Florida grows. In 2024, it reported more than $4.5 billion in earnings, while its parent company NextEra Energy posted nearly $7 billion in profit.

Schubert-Fontes argued customers are already being squeezed and pointed out the proposal includes a return on equity far exceeding industry norms.

"Part of FPL's proposal is that there's an 11.9% return on equity, which is far higher than the industry standard, which sits around, like, 9%," Schubert-Fontes noted. "This is money that goes directly into the pockets of shareholders."

The Public Service Commission has completed a series of in-person hearings. Local groups urged regulators to prioritize consumers, particularly vulnerable households and fixed-income seniors. A final decision is expected later this year.


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Optimism is falling and pessimism is rising among businesses getting a read on the U.S. economy, according to a new national survey.

The findings are from the Center for Audit Quality, which gathered feedback from the nation's leading public company audit firms. The firms serve clients in a wide range of industries, from retail to mining. The spring survey showed pessimism about the U.S. economy surged to 44%, compared to just 10% last fall. Meanwhile, optimism fell to 15%.

Julie Bell Lindsay, CEO of the center, said there are a handful of key factors behind the sentiments.

"Concern about a recession, ongoing geopolitical instability, and tariff uncertainty," Lindsay outlined. "Those are the top three areas where audit partners are seeing companies concerned over the next 12 months."

The Trump administration said it remains undeterred in applying broad-based tariffs in pursuit of fair trade. Financial analysts said the approach creates less predictability for businesses with the potential for layoffs, adding some of the tariff polices have resulted in legal setbacks. White House officials hope tariffs lead to more domestic manufacturing but experts cautioned it could take years.

Among respondents, 54% said companies in their sectors are reducing employee headcounts in the current economic landscape but nearly half also are making an effort to boost the skills of existing staff. Lindsay added artificial intelligence has major appeal right now.

"The companies in the industries that they audit are mainly pursuing the use of AI to enhance customer experiences, services and support, as well as automate some work processes," Lindsay explained.

Despite the Trump administration's interest in cryptocurrency, survey results show American companies feel the situation is not right yet to jump into those markets. Of those surveyed, 96% said their clients are not having talks right now about such investments.


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As eastern Kentucky communities attempt to bounce back from a string of natural disasters, more small businesses are struggling to get back on their feet.

An upcoming series of workshops led by the nonprofit Mountain Association and AppalReD Legal Aid this month aims to help small businesses in the region better prepare for emergencies.

Jessica Epperson, Mountain Association disaster recovery coordinator, said if businesses can get up and running as quickly as possible after catastrophe, communities benefit.

"They're going to cover the topics such as the death of a business owner, legal considerations, by-sale arrangements, key-person insurance, estate planning, just to help businesses really prepare for the other side of a disaster," Epperson outlined.

Workshop participants can sign up for free one-on-one meetings with an attorney. Workshops will be held in Hazard on Wednesday, London on Thursday, Ashland on June 17 and Prestonsburg on June 18.

Epperson pointed out while many businesses receive immediate funds in the aftermath of disaster, many are unable to navigate long-term challenges.

"We're hoping that businesses will be able to learn from each other, as well as find opportunities to improve disaster recovery," Epperson explained.

Epperson stressed Appalachian Kentucky's economic stability depends on local business owners.

"By having small businesses, it's ensuring the livelihood of our communities," Epperson added. "It's a dual way of being able to support both the people and the businesses within a certain area."

According to the U.S. Small Business Administration, between March 2022 and March 2023, more than 16,000 small businesses opened in Kentucky, and around 9,500 shut their doors. As of 2024, more than 380,000 small businesses operated across the Commonwealth, employing more than 685,000 people.