A Republican bill with no cosponsors
Last activity — 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.
In committee
Introduced and handed to a committee in the chamber it started in.
The committee holds it, and most bills are never heard from again. A hearing or a committee vote would be news; silence is the usual outcome, and it kills the bill without anyone voting against it.
Its path through Congress
- Introduced
- In Committee
What this bill would do
The ``Preventing Hospital Overbilling of Medicare Act'' aims to address incorrect billing by off-campus hospital locations. It seeks to promote site-neutral payments by redefining off-campus outpatient departments and removing certain exceptions. The bill requires these off-campus departments to be assigned a separate, unique health identifier from their main provider. It also establishes new billing requirements for Medicare and other health care providers. Additionally, the Secretary of Health and Human Services is directed to request that the National Association of Insurance Commissioners create a model Act or regulation regarding these billing issues.
Yes· 3 of 7
- Scored +5
Does this reduce what the federal government spends?
The bill promotes site-neutral payment policies to reduce expenditures for services furnished under Medicare.
- Scored +4
Would people over 65 be better off under this?
The bill aims to reduce overbilling for Medicare services used by seniors.
- Scored +4
Would retired people be better off under this?
The bill protects retirees from hospital overbilling through site-neutral payment policies.
The opposite
- Scored -2
Does this make health care easier to get in general?
The removal of the site-neutral exception for off-campus emergency departments may affect how emergency care is billed and accessed.
Who it would affect, and how
Potential Positive Impacts for People
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Reduction in Expenditures: The bill grants the Secretary authority to promote site-neutral payment policies to reduce expenditures related to items and services furnished under this part, specifically by preventing hospitals from billing off-campus services as if they were provided at the main hospital location (Section 2(a)(3)).
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Standardized Billing for Insurance: By requiring off-campus departments to use a separate, unique health identifier, the bill establishes specific billing standards for claims submitted to group health plans or health insurance issuers (Section 2(b)(1) and Section 2(c)(2)).
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Claim Rejection Capabilities: The Secretary will request a model Act or regulation that would allow health insurance issuers and group health plans to reject claims if the off-campus department does not bill according to the new requirements (Section 2(d)).
Potential Negative Impacts for People
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Changes to Emergency Department Exceptions: The bill removes a site-neutral exception for off-campus emergency departments, which will take effect before January 1, 2026 (Section 2(a)(2)).
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New Billing Requirements for Providers: Health care providers will be prohibited from submitting claims to group health plans or insurance issuers, and cannot hold individuals liable for items and services, unless they follow the new unique health identifier and specific transaction form requirements (Section 2(c)(2)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Tap or hover a score for the reason it gave.
- Demographic And Interest Groups
- Would retired people be better off under this? — The bill protects retirees from hospital overbilling through site-neutral payment policies. Would people over 65 be better off under this? — The bill aims to reduce overbilling for Medicare services used by seniors. Would households on low incomes be better off under this? — Standardized billing and site-neutral payments help prevent unexpected high costs for medical services.
- Economy And Finance
- Does this reduce what the federal government spends? — The bill promotes site-neutral payment policies to reduce expenditures for services furnished under Medicare. Does this give people more protection from unfair business practices? — The bill establishes stricter billing standards to prevent hospitals from overcharging for off-situs services.
- Governance And Ideology
- Does this make what the government does easier for the public to see? — The bill requires unique health identifiers for off-campus departments to clarify billing origins.
- Healthcare
- Does this put more money into Medicare, the health coverage for people over 65? — By promoting site-neutral payments, the bill aims to control and optimize Medicare expenditures. Does this make health care easier to get in general? — The removal of the site-neutral exception for off-campus emergency departments may affect how emergency care is billed and accessed.
- 4/24/2025
- 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.
- Introduced in House