S-2497 : Still Just a Bill

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The "Fair Billing Act," or S.2497, aims to amend Title XVIII of the Social Security Act, which deals with Medicare. The main purpose is to require each off-campus outpatient department of a healthcare provider to have its own unique identification number for billing purposes. Additionally, providers must attest that these off-campus departments comply with specific regulations.

• Unique Identifiers: Starting January 1, 2026, Medicare will not pay for services from off-campus outpatient departments unless they have a separate, unique health identifier.
• Attestation Requirement: Healthcare providers must submit attestations, initially and subsequently, confirming that their off-campus departments meet regulatory requirements.
• Review Process: The Secretary of Health and Human Services will establish a process, through rulemaking, to review these attestations, potentially including site visits or audits.
• Definition: An "off-campus outpatient department of a provider" is defined as a department not located on the provider's campus or within a specified distance of a remote hospital facility location.
• HHS OIG Analysis: By January 1, 2030, the Inspector General of the Department of Health and Human Services must submit an analysis of the review process to Congress, along with any recommendations.

In short, the bill seeks to increase transparency and accountability in Medicare billing for off-campus outpatient services.

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