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119-hr-8684119th CongressWALLET

Transparency in Billing Act of 2026

Sponsored By: Representative Foxx, Virginia [R-NC-5]

In Committee

Summary

This bill would require hospitals to include a separate, unique department-level health identifier on claims for services at off-campus outpatient departments and bar payment unless that identifier is provided. It also creates size-based civil penalties for hospitals that fail to comply and directs the Department of Labor to write implementing rules and a reporting process.

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 1 benefits, 0 costs, 1 mixed.

New hospital ID for off-campus billing

If enacted, hospitals would need a separate department-level health identifier under section 1173(b) for each off‑campus outpatient department. Group health plans and issuers would not be allowed to pay a claim for services at such a department unless the claim included that department identifier; that payment rule would begin for plan years starting on or after January 1, 2027. You would not be held personally liable for billed charges for those services unless the hospital included the required department identifier on the claim. The bill would use the off‑campus outpatient department definition in 42 C.F.R. 413.65 and require the Labor Department to write rules to implement the new requirements.

Fines and reporting for billing violations

If enacted, the Secretary would be authorized to assess civil fines against hospitals that violate the honest billing rules. Fines could be up to $300 per day for hospitals with 30 beds or fewer and up to $5,500 per day for hospitals with more than 30 beds, and would apply for each day a violation continues. The Secretary would also have to set up a process to receive reports of suspected violations within one year of enactment. The bill ties the bed-size calculation to the cited regulation in effect on enactment.

Sponsors & CoSponsors

Sponsor

Foxx, Virginia [R-NC-5]

NC • R

Cosponsors

  • Rep. Scott, Robert C. "Bobby" [D-VA-3]

    VA • D

    Sponsored 5/7/2026

Roll Call Votes

No roll call votes available for this bill.

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