Bill would end higher Medicare fees at off-campus hospital clinics
In committeeH.R. 3023Latest action
Sponsor: Victoria Spartz · Representative · IN
AIDecoded by AI · checked against the recordRead the official text
Official title: Preventing Hospital Overbilling of Medicare Act
119th Congress
Topics: Health care
Introduced:
Read the official bill on Congress.govIn plain words
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Starting in 2026, hospitals could no longer bill Medicare at higher hospital rates for care given at off-campus outpatient locations.
45-second read · 4 questions answered below
What does this do?
This bill stops hospitals from billing Medicare at hospital-level rates for services delivered at off-campus outpatient locations, including emergency departments, starting January 1, 2026. It redefines "off-campus outpatient department" and removes special billing exceptions, and requires each off-campus site to have its own unique billing identification number used on all Medicare and private insurance claims. HHS must also work with the National Association of Insurance Commissioners to develop model rules letting insurers reject claims that don't follow the new identification requirements.
Who does it affect?
The bill affects hospitals that operate off-campus outpatient facilities, insurance companies, and Medicare; patients receiving outpatient care are also affected.
Why does it matter?
Hospitals and insurers would need to update billing systems and identifiers to comply, and hospitals would lose the ability to bill hospital-level rates for care provided at smaller, off-site clinics.
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Read the official bill on Congress.govMake the call
Where does it stand?
- IntroducedApr 24, 2025
- House committeeYou are here · Apr 24, 2025
- House vote
- Senate
- The president's desk
Right now: a House committee is reviewing it. If the Senate changes it, it goes back to the House before reaching the president.
Latest action: — 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.