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Fair Billing Act

To amend title XVIII of the Social Security Act to require a separate identification number and an attestation for each off-campus outpatient department of a provider.

Introduced Jul 29, 2025

Latest action (Jul 29, 2025) Read twice and referred to the Committee on Finance.

Policy area
Issues
Healthcare

Summary

This bill requires Medicare to stop paying for services at off-campus outpatient departments unless they have separate identification numbers and provider attestations of compliance with federal regulations. Beginning January 1, 2026, providers must submit an initial attestation that their off-campus department meets regulatory requirements and submit subsequent attestations on a schedule determined by the Secretary. The Department of Health and Human Services has one year to establish a process for reviewing these attestations through site visits, remote audits, or other methods. The HHS Inspector General must report to Congress by January 1, 2030 on the effectiveness of this review process and provide recommendations.

AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.

Sponsor (1)

Actions (2)

  1. Jul 29, 2025 Read twice and referred to the Committee on Finance. · senate
  2. Jul 29, 2025 Introduced in Senate

Similar bills (6)

Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.

Full text

IN THE SENATE OF THE UNITED STATES

July 29, 2025

Ms. Hassan (for herself and Mr. Marshall) introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To amend title XVIII of the Social Security Act to require a separate identification number and an attestation for each off-campus outpatient department of a provider.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the “Fair Billing Act”.

SEC. 2. REQUIRING A SEPARATE IDENTIFICATION NUMBER AND AN ATTESTATION FOR EACH OFF-CAMPUS OUTPATIENT DEPARTMENT OF A PROVIDER.

(a) In General.—Section 1833(t) of the Social Security Act (42 U.S.C. 1395l(t)) is amended by adding at the end the following new paragraph:

“(23) Use of unique health identifiers; attestation.—

“(A) In general.—No payment may be made under this subsection (or under an applicable payment system pursuant to paragraph (21)) for items and services furnished on or after January 1, 2026, by an off-campus outpatient department of a provider (as defined in subparagraph (C)) unless—

“(i) such department has obtained, and such items and services are billed under, a standard unique health identifier for health care providers (as described in section 1173(b)) that is separate from such identifier for such provider;

“(ii) such provider has submitted to the Secretary, during the 2-year period ending on the date such items and services are so furnished, an initial provider-based status attestation that such department is compliant with the requirements described in section 413.65 of title 42, Code of Federal Regulations (or a successor regulation); and

“(iii) after such provider has submitted an attestation under clause (ii), such provider has submitted a subsequent attestation within the timeframe specified by the Secretary.

“(B) Process for submission and review.—Not later than 1 year after the date of enactment of this paragraph, the Secretary shall, through notice and comment rulemaking, establish a process for each provider with an off-campus outpatient department of a provider to submit an initial and subsequent attestation pursuant to clauses (ii) and (iii), respectively, of subparagraph (A), and for the Secretary to review each such attestation and determine, through site visits, remote audits, or other means (as determined appropriate by the Secretary), whether such department is compliant with the requirements described in such subparagraph.

“(C) Off-campus outpatient department of a provider defined.—For purposes of this paragraph, the term ‘off-campus outpatient department of a provider’ means a department of a provider (as defined in section 413.65 of title 42, Code of Federal Regulations, or any successor regulation) that is not located—

“(i) on the campus (as defined in such section) of such provider; or

“(ii) within the distance (described in such definition of campus) from a remote location of a hospital facility (as defined in such section).”.

(b) HHS OIG Analysis.—Not later than January 1, 2030, the Inspector General of the Department of Health and Human Services shall submit to Congress—

(1) an analysis of the process established by the Secretary of Health and Human Services to conduct the reviews and determinations described in section 1833(t)(23)(B) of the Social Security Act, as added by subsection (a) of this section; and

(2) recommendations based on such analysis, as the Inspector General determines appropriate. <all>

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