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HR3417FEDERALIN_COMMITTEE

The FAIR Act: New Billing Rules for Off-Campus Hospital Clinics

Original title: FAIR Act

December 17, 2024

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Where This Stands

Introduced
Committee
Floor Vote
Passed
Signed

Currently IN_COMMITTEE. The next step in the legislative lifecycle is Floor Vote.

Version history

Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.

View official text →

The Frame

What this does

By requiring separate identifiers for off-campus clinics, the bill creates a clearer paper trail for medical services, which may impact how hospitals are reimbursed and how patients are billed for outpatient care.

Who is mentioned in the record

Potentially affected actors named in the source documents. Mention is not a position.

Hospitals with off-campus outpatient departments

Must obtain and use unique health identifiers for each off-campus location when billing for services.

Medicare beneficiaries

Their medical claims for services at off-campus departments will be processed using new, specific identifiers.

Health insurance issuers

Must receive claims that comply with the new unique identifier requirements for off-campus outpatient services.

What changed

Current stage: IN_COMMITTEE.

What's next

Floor Vote.

Background

  • The FAIR Act addresses long-standing debates regarding 'site-neutral' payments, where hospitals may receive higher reimbursement rates for services performed in outpatient departments compared to independent physician offices. context

Summary

This bill requires off-campus hospital outpatient departments to use unique identification numbers when billing for services, starting January 1, 2025. This change aims to standardize how these facilities submit claims to Medicare, private health plans, and insurance issuers.

Key Facts

You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.

Frequently Asked Questions

What is an off-campus outpatient department?
The bill refers to definitions in section 1833(t)(21)(B) of the Social Security Act, generally describing hospital-affiliated clinics located away from the main hospital campus.
When do these new billing requirements take effect?
The requirements apply to items and services furnished on or after January 1, 2025.
Will this change how I am billed for my doctor's visit?
The bill requires providers to use specific identifiers on billing forms; it does not explicitly change the amount a patient is charged, but it aims to ensure billing transparency for services at these specific locations.

Why It Matters

By requiring separate identifiers for off-campus clinics, the bill creates a clearer paper trail for medical services, which may impact how hospitals are reimbursed and how patients are billed for outpatient care.

News Coverage

No news coverage found yet. Articles are indexed twice daily.

Lobbying Activity

AARP

$4,110,000

2026

HEALTH ISSUESMEDICARE/MEDICAIDLAW ENFORCEMENT/CRIME/CRIMINAL JUSTICEPHARMACY

P.L. 119-21, One Big Beautiful Bill Act H.R. 8867, Planning for Long-term Aging Needs (PLAN) Act H.R. 5861, Legacy Act of 2025 H.R. 9393, the Lower Costs, More Transparency Act. H.R. 9396, the Prior Authorization Accountability Act. S. 4916, the Aging with Artificial Intelligence Act. H.R. 8100, Safe Staffing Saves Lives Act. S. 3886, Nurses Belong in Nursing Homes Act. H.R. 6766/S. 3492, the Essential Caregivers Act of 2025. H.R. 7966/S. 4118, Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act. S. 2120, the Older Americans Act Reauthorization Act of 2025 H.R. 5575, the Firefighters Assisting Seniors to Emergency Response (FASTER) Act of 2025. H.R. 3954/S. 4641, Improving Access to Medicare Coverage Act. H.R.5554/S.2831, Stand Strong for Medicare Act. S. 3439/H.R. 6735, Connecting Caregivers to Medicare Act and efforts related to the bill S. 1227/H.R. 2491, Alleviating Barriers for Caregivers Act S. 668/H.R. 3183, Supporting Access to Falls Education and Prevention and Strengthening Training Efforts and Promoting Safety Initiatives (SAFE STEPS) for Veterans Act of 2025 CMS-1851-P, Hospice Proposed rule. CMS-1843-P, Skilled Nursing Facility Proposed rule. CMS-1844-P, Home Health Proposed rule. No bill number. Health care transparency. No bill number. Discussed use of artificial intelligence and health data technology. No bill number. Discussed health-related policies and activities around the fall respiratory virus season. No bill number. Discussed health insurance affordability proposals. No bill number. Discussed Nursing Home staffing standards, safety, and quality. No bill number. Discussed Nursing home transparency and ownership requirements. No bill number. Discussed home health, hospice, and long-term care. No bill number. Discussed falls prevention. No bill number. Discussed social isolation. No bill number. Discussed HUD Assisted Living Requirements No bill number. Discussed family caregiving. No bill number. Discussed AARP paper on Medicare Caregiver Training Services. No bill number. Discussed Medicaid community engagement interim final rule, including the family caregiver exemption. No bill number. Discussed the paid direct care workforce in long-term care. No bill number. Discussed the unaffordability of long-term care. No bill number. Discussed Money Follows the Person Rebalancing Demonstration Program and Medicaid HCBS spousal impoverishment protections. No bill number. Discussed Medicaid fraud and family caregivers, Medicaid self-direction programs. No bill number. Discussed sandwich generation family caregiver hearing and submitted a statement for the record discussing family caregivers and sandwich generation caregivers, programs that support them, AARP caregiving resources, and federal policies to support sandwich generation caregivers and caregivers more broadly. No bill number. Discussed long-term care. No bill number. CMS-2453-NC; Medicaid Program; 2028 Medicaid Home and Community-Based Services Quality Measure Set Submitted comments No bill number. Discussed expanding access to home care. No bill number. Discussed the increasing cost of home care No bill number. Discussed HSA use for telehealth chronic care management services/subscriptions. No bill number. Discussed artificial intelligence and technology

1607 STRATEGIES, LLC

on behalf of American Property Casualty Insurance Association

2026

INSURANCEBUDGET/APPROPRIATIONSTORTS

Issues relating to the reauthorization of the National Flood Insurance Program and other Issues related to flood insurance. Issues related to the Fair Credit Reporting Act. Issues regarding environmental policies and their consideration by insurers and state insurance regulators. Issues related to the Terrorism Risk Insurance Program. H.R. 7128, TRIA Program Reauthorization Act of 2026, all provisions.

1607 STRATEGIES, LLC

on behalf of American Fintech Council

2026

FINANCIAL INSTITUTIONS/INVESTMENTS/SEC

Issues related to fintech and banks-as-a-service, earned wage access, fintech legislation, and online lending. Issues related to earned wage access. H.R.940, FAIR Exams Act, all provisions. H.R. 4437, Supervisory Modifications for Appropriate Risk-based Testing Act of 2025 (SMART Act of 2025), all provisions. H.R. 4478, Tailored Regulatory Updates for Supervisory Testing Act of 2025 (TRUST Act of 2025), all provisions.

60 Plus Association

2026

TAXATION/INTERNAL REVENUE CODEENVIRONMENT/SUPERFUNDCOPYRIGHT/PATENT/TRADEMARKHEALTH ISSUES

Signed a coalition letter opposing any efforts to raise the corporate tax rate above the 21% level set in the 2017 Tax Cuts and Jobs Act (TCJA). Signed a coalition in support of the Family Business Legacy Act, H.R. 6329. This legislation creates parity in the tax code between the estate and gift taxes by allowing an estate tax deduction for contributions to 501(c)(4), (c)(5), and (c)(6) organizations. Signed a coalition letter urging opposition to proposals that would raise taxes on carried interest investment income.The letter is urging Congress to reject the misnamed Carried Interest Fairness Act, legislation recently reintroduced by Senators Tammy Baldwin, Elizabeth Warren, Bernie Sanders, and other progressive members of Congress. This legislation that would increase the tax rate on carried interest investment by 70%, from 23.8% to 40.8%. Signed a coalition letter in support of H.R.574 - ALIGN Act and highlight the 100% bonus depreciation provision's importance as the tax cut reauthorization efforts continue. Signed a coalition to support of repealing IRA's green new deal subsidies in reconciliation to pay for tax cuts. Signed a coalition letter regarding digital services taxes (DST) in an effort to stop Canadas imposition of a discriminatory digital services tax (DST) on U.S. firms and your efforts to include restrictions on the imposition of DSTs and other unfair digital policies in recently announced trade agreements-providing a model for future trade negotiations. Signed a coalition letter urging the President to index capital gains for inflation.

1607 STRATEGIES, LLC

on behalf of American Property Casualty Insurance Association

2026

INSURANCEBUDGET/APPROPRIATIONSTORTS

Issues relating to the reauthorization of the National Flood Insurance Program and other Issues related to flood insurance. Issues related to the Fair Credit Reporting Act. Issues regarding environmental policies and their consideration by insurers and state insurance regulators. Issues related to the Terrorism Risk Insurance Program. H.R. 7128, TRIA Program Reauthorization Act of 2026, all provisions.

1607 STRATEGIES, LLC

on behalf of American Fintech Council

2026

FINANCIAL INSTITUTIONS/INVESTMENTS/SEC

Issues related to fintech and banks-as-a-service, earned wage access, fintech legislation, and online lending. Issues related to earned wage access. H.R.940, FAIR Exams Act, all provisions. H.R. 4437, Supervisory Modifications for Appropriate Risk-based Testing Act of 2025 (SMART Act of 2025), all provisions. H.R. 4478, Tailored Regulatory Updates for Supervisory Testing Act of 2025 (TRUST Act of 2025), all provisions.

BARNES & THORNBURG, LLP

on behalf of PRECAST/PRESTRESSED CONCRETE INSTITUTE

MEHLMAN CONSULTING, INC.

on behalf of NORTHERN TRUST

LIBERTY PARTNERS GROUP, LLC

on behalf of NEPHROLOGY ASSOCIATES OF NORTHERN ILLINOIS AND INDIANA (DVAC REF)

LIBERTY PARTNERS GROUP, LLC

on behalf of AMERICAN VEIN & LYMPHATIC SOCIETY (OFFICE-BASED FACILITY ASSN OBFA) (FKA USPA)

Sponsors

Discoveries

Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.

policy shift90% confidence

Standardization of Outpatient Billing

The bill represents a move toward greater granularity in hospital billing by forcing off-campus departments to be identified separately from the main hospital entity.

Connected Entities

bill_number42 U.S.C. 1395cc(a)(1)Section of the Social Security Act regarding Medicare billingMap →
personKuster, AnnieCo-sponsor of the billMap →
bill_number42 U.S.C. 1395ww(d)(2)(D)Definition of a rural area used for compliance reviewsMap →
bill_number42 U.S.C. 1395l(t)(21)(B)Section of the Social Security Act defining off-campus outpatient departmentsMap →
personHern, PatrickLead sponsor of the billMap →
organizationMedicareThe primary healthcare program affected by the billMap →
organizationHealth and Human ServicesThe agency responsible for implementing and overseeing the bill's provisionsMap →
bill_number42 U.S.C. 1320d-2Section of the Social Security Act being amendedMap →
bill_numberSocial Security ActThe foundational legislation being amendedMap →
otherCode of Federal RegulationsThe regulatory framework being updatedMap →

Analysis Score

0–100
  • Significance65
    How much this matters to a regular citizen
  • Controversy20
    Intensity of disagreement among stakeholders
  • Entertainment5
    Compellingness for a non-policy-wonk reader
  • Buzz15
    Current news / social attention level

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