Fair Billing Act

The Fair Billing Act would amend Medicare billing rules to increase transparency at hospital-owned clinics and doctor's offices located away from the main hospital campus. Under this proposal, each off-campus outpatient department would need to obtain its own unique billing identification number separate from the main hospital's identifier, rather than billing under the hospital's number. Hospitals would also be required to submit attestations confirming that these off-campus locations comply with federal regulations governing provider-based departments. These requirements would take effect on January 1, 2026, and Medicare would not pay for services at non-compliant locations.

The bill aims to address what supporters describe as unfair billing practices where patients receive unexpectedly high bills after their independent doctor's office or clinic is purchased by a hospital. By requiring separate billing identifiers, patients would see clearer information about where they received care, making it easier to identify when they are being charged higher facility fees. The legislation would also help prevent hospitals from using their main provider number to obscure the true location and cost of care, potentially reducing unnecessary consolidation of independent medical practices into hospital systems.