Fair Billing Act

This bill aims to make hospital billing clearer and more consistent for care given at clinics that are away from a hospital’s main campus. Each off‑campus outpatient department must have its own unique ID number for billing, and the hospital must confirm (and later re‑confirm) that the site meets federal rules. If a site doesn’t do this, Medicare won’t pay for care given there starting January 1, 2026 (unique ID; initial and later attestations; payment cutoff date) . The government will set up a process within a year to collect and check these confirmations, which can include site visits or remote audits. The bill also defines what counts as an off‑campus outpatient department for these rules . An independent check of how well this system works is due by January 1, 2030 .

• Who is affected: Hospitals and health systems with outpatient sites not on the main hospital campus; Medicare billing at those sites .
• What changes: Each off‑campus site needs its own billing ID and must submit initial and later confirmations that it follows rules; Medicare can withhold payment if they don’t comply; HHS will review compliance through a formal process .
• When: Payment rules start January 1, 2026; HHS sets the process within one year of the law; an oversight report is due by January 1, 2030 .