S 2497 — Fair Billing Act

Bill Text

• Introduced Introduced in Senate Current html July 29, 2025

Compared against current U.S. Code AI-generated reading aid — verify against the official bill.

The bill introduces requirements for off-campus outpatient departments of a provider to obtain a unique health identifier and submit attestations for compliance to receive reimbursement.

• 42 U.S.C. 1395l(t)

  (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.

  This addition establishes new requirements for off-campus outpatient departments to obtain a unique identifier and submit attestations for compliance in order to receive Medicare payments.

• 42 U.S.C. 1395l(t)

  (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.

  This provision mandates the establishment of a review process for attestations from off-campus outpatient departments to ensure compliance.

• 42 U.S.C. 1395l(t)

  (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).

  This defines the term 'off-campus outpatient department of a provider' for clarity in the context of the new requirements.

Action History

1. July 29, 2025

   Introduced in Senate

2. July 29, 2025

   Read twice and referred to the Committee on Finance.

Sponsors

• Margaret Wood Hassan · Primary
• Roger Marshall · Cosponsor

Subjects