S. 2497Senate119th Congress (2025-2027)In Committee

Fair Billing Act

Introduced July 29, 2025

AI-Generated Summary

Updated November 23, 2025 at 11:07 PM UTC

The Fair Billing Act would change Medicare rules so that any outpatient department located away from a provider’s main campus must use its own unique health identifier and prove it meets compliance standards before it can receive payment. Providers must regularly attest to the department’s compliance, and the Health and Human Services Secretary will set up the submission and review process. An HHS Inspector General report on the effectiveness of this system is required by 2030.

Key Provisions

  • Each off‑campus outpatient department of a health‑care provider must obtain its own unique health identifier that is separate from the provider’s main identifier, and must bill services using that identifier.
  • The provider must submit an initial compliance attestation to the Secretary of Health and Human Services for each such department, and then submit follow‑up attestations on a schedule set by the Secretary; payments are denied if these attestations are missing or the department is not compliant.
  • Within one year of the bill’s enactment, HHS must create rules describing how providers submit attestations and how the Secretary will review them (including site visits, remote audits, etc.).
  • The Inspector General of HHS must, by Jan. 1, 2030, analyze the Secretary’s review process and provide Congress with a report and recommendations.

Legislative Activity

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SenateIntro Referral Latest Action

Read twice and referred to the Committee on Finance.

July 29, 2025

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SenateIntro Referral

Introduced in Senate

July 29, 2025

SenateIntro Referral

Read twice and referred to the Committee on Finance.

July 29, 2025

Bill Text

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Introduced in SenateIssued July 29, 2025

II

119th CONGRESS

1st Session

S. 2497

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.

1.

Short title

This Act may be cited as the Fair Billing Act.

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.