Fair Billing Act
Sponsored By: Senator Maggie Hassan
Introduced
Summary
This bill would require separate unique health identifiers and regular attestations for off‑campus outpatient departments before Medicare will pay for their services. It targets how hospitals bill for off‑campus departments and sets deadlines and review rules for compliance.
Show full summary
- Hospitals and providers with off‑campus outpatient departments would need a distinct Medicare provider identifier for each OCOD and must file an initial attestation and subsequent attestations to keep receiving Medicare payments. One key date is January 1, 2026 for payment eligibility.
- Medicare beneficiaries would see that services furnished at an OCOD are not payable by Medicare unless that OCOD meets the new identifier and attestation rules.
- The Department of Health and Human Services Secretary would have to set up a notice-and-comment process within one year for submitting attestations and for reviewing compliance through site visits, remote audits, or other means.
- The Department’s Inspector General must report to Congress by January 1, 2030 with an analysis of the review process and any recommendations.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 0 benefits, 1 costs, 0 mixed.
New Medicare rules for off-campus care
If enacted, Medicare would not pay for care at an off-campus outpatient department after Jan 1, 2026. The department must use its own standard provider identifier separate from the main provider. The provider must file an initial attestation during the two years before services are furnished. The provider must file a later attestation within the timeframe the Secretary sets. The Secretary would have one year after enactment to make rules for how attestations are submitted and reviewed. The Secretary could check compliance by site visits, remote audits, or other means. The bill would define off-campus departments using the campus and distance rules in 42 C.F.R. §413.65. HHS's Inspector General would report to Congress by January 1, 2030 on the review process and give recommendations.
Sponsors & CoSponsors
Sponsor
Maggie Hassan
NH • D
Cosponsors
Roger Marshall
KS • R
Sponsored 7/29/2025
Roll Call Votes
No roll call votes available for this bill.
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