Fair Billing Act

The Fair Billing Act is a proposed bill introduced in the Senate in 2025. It would change Medicare billing rules for off-campus outpatient departments (OCOPDs) of providers. Starting January 1, 2026, no Medicare payment would be made for items and services furnished by an OCOPD unless the department uses a separate standard unique health identifier for health care providers (UHID) for that department, and the provider has completed a two-stage attestation process confirming provider-based status and ongoing compliance. The Secretary of Health and Human Services would establish a process within one year to collect these attestations and review them through site visits or audits. The Inspector General would later analyze the process by 2030 and provide recommendations. An OCOPD is defined by existing CFR criteria as a provider department not located on the provider’s main campus or within the specified distance from a hospital campus. In short, the bill aims to tighten Medicare billing for off-campus outpatient sites by requiring separate provider identifiers and formal attestations of compliance, with federal oversight and a defined implementation timeline.