# 119-hr-3023: Preventing Hospital Overbilling of Medicare Act

119-hr-3023, Preventing Hospital Overbilling of Medicare Act, is a 119th Congress bill sponsored by Rep. Spartz, Victoria [R-IN-5] (R-IN); status introduced; PRIA reads it as touching household money (as of 2026-06-13).

- Canonical: https://policyrisk.com/legislation/119-hr-3023
- As of: 2026-06-13
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-3023
- Congress: 119
- Title: Preventing Hospital Overbilling of Medicare Act
- Status: introduced
- Introduced: 2025-04-24
- Sponsor: Rep. Spartz, Victoria [R-IN-5] (R-IN)
- Cosponsors: 0
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-06-13

## Summary

**Site-neutral payments** are the bill’s main goal. It would stop hospitals from using exceptions to bill off-campus outpatient departments at higher hospital rates and require separate identifiers and billing formats for those departments. - Hospitals and providers: Would remove exceptions that let some off-campus outpatient departments be paid like on-campus hospital sites for Medicare, with the change applying to services furnished on or after January 1, 2026. - Medicare program and beneficiaries: Would push Medicare toward broader site-neutral payments for off-campus departments to reduce expenditures and prevent hospitals from billing at hospital rates. - Off-campus outpatient departments: Would have to use a separate national provider identifier (NPI) by January 1, 2026 and bill using HIPAA X12 837P transactions or CMS 1500 forms for services on or after that date. - Health plans and state regulators: Creates a new section that bars group health plans and issuers from paying claims for an off-campus department unless they use the department’s separate NPI and specified claim forms, and directs the National Association of Insurance Commissioners (NAIC) to adopt a model law within six months to enforce this. *Would aim to lower federal Medicare spending by expanding site-neutral payments for off-campus outpatient departments starting in 2026.*

## Provisions PRIA read

- New billing IDs for off-campus hospital care: benefit, medium. If enacted, off-campus hospital departments would need their own unique ID by January 1, 2026. Medicare, including Medicare Advantage, and private plan claims for care at these sites would have to use that ID and be sent on the HIPAA X12 837P or CMS 1500 form (or a successor). Providers would not b…
- Medicare payment changes for off-campus care: mixed, high. This bill would change how Medicare treats care at hospital locations that are not on the main campus. Starting January 1, 2026, more sites could be classified as off‑campus departments under a tighter definition. The special site‑neutral rule for off‑campus emergency rooms would only apply to care…

## Related bills

- 119-hr-5582: Patients Deserve Price Tags Act
- 119-hr-3222: SMART Health Care Act
- 119-hr-2548: Sanctioning Russia Act of 2025
- 119-hr-1357: Susan Muffley Act of 2025
- 119-hr-3184: PFAS Alternatives Act
- 119-hr-10463: Combat Veterans Retirement Restoration Act

## Sources
- [119-hr-3023 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/3023)

## Related
- [119-hr-5582: Patients Deserve Price Tags Act](https://policyrisk.com/legislation/119-hr-5582)
- [119-hr-3222: SMART Health Care Act](https://policyrisk.com/legislation/119-hr-3222)
- [119-hr-2548: Sanctioning Russia Act of 2025](https://policyrisk.com/legislation/119-hr-2548)
- [119-hr-1357: Susan Muffley Act of 2025](https://policyrisk.com/legislation/119-hr-1357)
- [119-hr-3184: PFAS Alternatives Act](https://policyrisk.com/legislation/119-hr-3184)
- [119-hr-10463: Combat Veterans Retirement Restoration Act](https://policyrisk.com/legislation/119-hr-10463)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-3023 (as of 2026-06-13).