Claire Galt
•9/18/2026
LEE COUNTY, Fla. — After WINK News found a Lee Health doctor's office was not following the health system's process for warning patients about potential facility fees, more patients reached out saying they had been hit with similar charges.
Now, WINK News has checked more Lee Health offices and dug into the federal rules surrounding hospital-based facilities.
Some Lee Health doctors' offices are designated as hospital outpatient departments, or HODs. They may look like regular doctors' offices, but they are considered part of a hospital.
Depending on a patient's insurance, that can mean a separate facility fee on top of the cost of seeing the doctor.
Lee Health says its HOD locations operate under additional hospital-level requirements and that services at those locations are billed as hospital outpatient care.
Cathy Kaiser first brought the issue to WINK News after receiving a $59 facility fee on top of her copay at Lee Health Adult Endocrinology on Colonial Center Drive.
Lee Health spokesperson Jaclyn Bevis told WINK News its HOD offices have signs posted warning patients that a facility fee may apply.
But when WINK News anchor Claire Galt went to Kaiser's office, there was no sign posted.
When Galt asked staff where it was, an employee pulled the sign out of a drawer.
After Galt brought what she found to Lee Health's attention, a sign was posted at the office.
“My fight today is not so much the extra $59 over and above my copay. It’s the lack of transparency.” Kaiser said.
After Galt's first story aired, her inbox filled with messages from patients who said they had also received facility fees they did not expect.
Some said the additional charges caused them to switch doctors or offices.
A day after the report, Galt visited additional Lee Health HOD locations on Bass Road and Summerlin Road.
This time, every office she checked had a warning sign posted.
WINK News does not know when those signs were put up.
WINK News also reviewed federal Medicare regulations governing provider-based facilities.
Under Section 413.65 of Title 42 of the Code of Federal Regulations, hospital-based offices must make patients aware that they are part of the hospital system and that they will be billed accordingly.
The federal rule does not specifically require that notification to come in the form of a facility-fee warning sign.
Kaiser, however, says she was never told that her visit could come with a facility fee.
Lee Health, however, has told WINK News that signs are posted at its off-campus HOD offices to notify patients that a facility fee may apply.
Some states have passed additional laws specifically addressing facility fees.
According to the advocacy group United States of Care, 20 states have passed laws addressing facility fees. Florida is not among the states identified by the group.
Colorado, for example, has requirements addressing facility-fee notifications, including signs in common areas and notification when an appointment is made that a facility fee may be charged.
WINK News has continued communicating with Lee Health about facility fees and has requested an on-camera interview to discuss its process for notifying patients. We will continue requesting one.
Lee Health publishes a list of Lee Physician Group locations designated as hospital outpatient departments.
To find the list of Lee Health HOD offices, click here. Scroll down to Frequently Asked Questions on Billing Resources and select the drop-down bar: 'Which LPG locations are Hospital Outpatient Departments (HOD)?'
