H.R. 3237House118th Congress (2023-2025)In Committee

To amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department.

Sponsored by John JoyceRep. John Joyce (R-PA)
Introduced May 11, 2023

AI-Generated Summary

Updated January 20, 2026 at 7:28 AM UTC

The bill amends the Social Security Act to require that every off‑campus outpatient department of a Medicare‑eligible provider use its own unique health identifier when billing for items and services, and to require the provider to submit an attestation to CMS confirming the department meets compliance standards. The rules apply to all providers with outpatient departments located outside the provider’s main campus or beyond the defined campus distance, affecting payments for services starting January 1 2026.

Key Provisions

  • Off‑campus outpatient departments must obtain and bill using a unique health identifier separate from the provider’s main identifier.
  • Providers must submit an attestation to the Secretary of HHS (CMS) confirming each department complies with applicable regulations, covering a two‑year period ending on the date services are furnished.
  • CMS must create, within one year of enactment, a rule‑making process for submitting and reviewing these attestations, including site visits or remote audits.
  • No Medicare payment will be made for items or services from an off‑campus department that lacks the unique identifier or the required attestation after Jan 1 2026.
  • The term “off‑campus outpatient department” is defined as a department not located on the provider’s campus or within the campus‑distance from a remote hospital location.

Legislative Activity

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3 earlier actions
HouseCommittee Latest Action

Referred to the Subcommittee on Health.

December 17, 2024

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HouseIntro Referral

Introduced in House

May 11, 2023

HouseIntro Referral

Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

May 11, 2023

HouseCommittee

Referred to the Subcommittee on Health.

May 12, 2023

HouseCommittee

Referred to the Subcommittee on Health.

December 17, 2024

Bill Text

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Introduced in HouseIssued May 11, 2023

I

118th CONGRESS

1st Session

H. R. 3237

IN THE HOUSE OF REPRESENTATIVES

May 11, 2023

Mr. Joyce of Pennsylvania (for himself and Mr. Sarbanes) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department.

1.

Requiring a separate identification number and an attestation for each off-campus outpatient department of a provider

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 unique health identifier (as established pursuant to standards described in section 1173(b)) that is separate from such identifier for such provider; and

(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 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).

(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 attestation pursuant to subparagraph (A)(ii), and for the Secretary to review each such attestation and determine, through site visits or through remote audits (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).

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