Sponsors (2)
The bill increases billing transparency and government oversight for off‑campus outpatient departments—benefiting Medicare beneficiaries and payers—but creates compliance costs, payment risk for providers (potentially reducing access), and privacy concerns that must be managed.
Medicare beneficiaries will face clearer billing and fewer provider-identity errors because off‑campus outpatient departments must use a distinct unique health identifier when billing.
Hospitals and health systems will have clearer rules for provider-based status, improving billing consistency and helping reduce improper Medicare payments over time.
Taxpayers and providers will benefit from an independent HHS OIG review (due Jan 1, 2030) that will analyze current payment determinations for off‑campus departments and issue recommendations to improve oversight.
Hospitals with off‑campus outpatient departments (especially small or rural ones) risk losing Medicare payments if they fail to obtain separate identifiers or timely attestations, which could reduce local access to outpatient services.
Providers will incur increased administrative burden and compliance costs to implement separate identifiers, attestations, and potential audits, which could be passed on to patients or insurers and raise health care prices.
Medicare beneficiaries face heightened privacy and data‑security risks from the creation and use of separate unique health identifiers and expanded review/audit processes unless strong protections are enforced.
Based on analysis of 2 sections of legislative text.
Introduced July 29, 2025 by Margaret Wood Hassan · Last progress July 29, 2025
Conditions Medicare payment for outpatient services provided at off‑campus hospital departments on the provider having a separate standard unique health identifier and on the provider submitting a provider‑based status attestation showing compliance with regulations. Requires the Department of Health and Human Services to issue notice‑and‑comment regulations within one year to set up attestation submission and review procedures and directs the HHS Office of Inspector General to report to Congress with analysis and recommendations by January 1, 2030. Payments for items and services furnished on or after January 1, 2026, to an off‑campus outpatient department are barred unless the department meets the unique‑identifier and attestation requirements and the provider completes periodic subsequent attestations under timelines the Secretary will set.