Maine lawmakers are calling for greater transparency in how hospitals and other health care centers charge so-called facility fees.

A legislative task force says providers should notify patients prior to a scheduled service if they'll be charged an added fee, and recommends the fees be eliminated for telehealth services or outpatient evaluations, including visits to a doctor's office.

Ann Woloson, executive director of Consumers for Affordable Health Care, said patients deserve to know when and how these fees are assessed.

"What is it that the facility fees are actually paying for," said Woloson, "and how much is really necessary to cover the cost incurred by hospitals that are billing these fees?"

Woloson called the recommendations "a good first step" in strengthening consumer protections, but some health care facilities say the fees are needed to cover twenty-four hour care, increased security and supplies.

Consumer advocates say facility fees can range from $15 to thousands of dollars, and are adding to the growing concern of medical debt.

Surveys show half of Maine households carry medical debt, the majority of which stems from hospital bills.

Woloson said while it's important that hospitals can remain open, consumers shouldn't bear the burden of high health care prices.

"More needs to be done to try to control costs," said Woloson, "while at the same time improving access to the health care services that Mainers, particularly in rural areas of the state, need."

Woloson said high health care costs are impacting peoples' everyday lives.

One in three Mainers report struggling to pay for basic necessities, such as food, heat, or housing within the past two years as a result of a medical bill.

And nearly one in three Mainers has recently been contacted by a collection agency about an overdue hospital bill.

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.

Minnesotans this month have a chance to share their thoughts on how the state should distribute home energy rebates. With federal incentives coming in, officials want to ensure equal access to new technologies.

Starting next Wednesday, the Commerce Department will host a series of public hearings on rebates funded through the Inflation Reduction Act. Mia Naseth-Phillips, the department's director of energy programs for inclusion and equity, said this aid can help eligible households get appliances and heating and cooling systems that reduce their energy burden. She said they especially want to reach people who otherwise couldn't afford emerging technologies that make a home's carbon footprint smaller.

"And that becomes a repeated theme," she said, "that, 'I'm having a hard time paying my bills. They're very high. How can I have something that is continually combating the high costs of energy use?'"

It isn't just affordability. Naseth-Phillips said messaging about home energy upgrades often doesn't reach underserved communities. The department hopes the meetings are informative as it gathers feedback on how the rebates should be carried out. Officials have said a challenge is creating a robust network of certified contractors trained for specific installations. A list of the hearing sites and times is on the Commerce Department website.

Eric Fowler, senior policy associate for buildings for the group Fresh Energy, said heat pumps are some of the more "glitzy" items getting attention these days. However, he cited other rebate opportunities that might not be as glamorous but still get the job done.

"These rebates can also help with insulation and air sealing," he said, "which are, depending on the state of your home, might be actually more important than a solar panel."

He said there will be chances to offset the cost of upgrading a home's electrical box, along with thicker wires, to accommodate increased use of clean energy sources.

The first hearing, next Wednesday, is in Minneapolis. Remaining events are spread out across the state, including St. Cloud, Bemidji, Fergus Falls and Duluth. A hearing in Mankato was scrapped and hasn't yet been rescheduled.

Fifth Third Bank just agreed to pay a $20 million fine to settle charges it forced car buyers to purchase unnecessary insurance and created fake accounts in customers' names.

The Consumer Financial Protection Bureau said the bank required customers with car loans to buy insurance, even if they already had coverage or got their own within 30 days.

Rosemary Shahan, president of Consumers for Auto Reliability and Safety, said some customers then could not afford the payments.

"There were about 1,000 consumers who had their cars repossessed," Shahan recounted. "Most people rely on their car to get to and from work, and get their kids to school, and get to medical appointments. So that is really devastating when they lose their car."

In a statement, Fifth Third Bank said it shut down the protection insurance program in 2019 and is taking action to set things right. The money from the fine will go to a fund to reimburse 35,000 customers who were harmed. The court order also bans the company from setting employee sales goals incentivizing fraudulently opening accounts.

Shahan pointed out car dealers sometimes make verbal promises differing from the written contract or fail to even print out the financing paperwork. She wants people to know they cannot be required to buy insurance if they already have coverage.

"The best way to avoid all these scams is join a credit union, get your own financing, and deal with a reputable bank," Shahan recommended. "Don't let the dealer get financing for you."

In 2015, Fifth Third Bank was ordered to pay more than $21 million in fines for discriminatory auto loan pricing and for illegal credit card practices.