Fair Billing Act

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 2497 Introduced in Senate (IS)]

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119th CONGRESS
  1st Session
                                S. 2497

 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.


_______________________________________________________________________


                   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.
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