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Transparent Medical Billing: New Rules for Hospitals and Insurers

This act aims to increase transparency in medical billing, especially for services provided at off-campus hospital departments. Starting in 2024, hospitals must include a unique identifier for the location where services were rendered for claims to be paid by insurers. This is intended to prevent unclear charges and protect patients from unexpected costs.
Key points
Hospitals must provide a unique identifier for services rendered at off-campus outpatient departments for claims to be paid.
Health insurance plans will not be able to pay claims that do not include the required service location identifier.
Patients will not be held liable for services if the hospital fails to meet the identifier requirements.
Hospitals can face daily penalties of up to $5,500 for violations, depending on their size.
These new rules take effect for plan years beginning on or after January 1, 2024.
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Additional Information
Print number: 118_HR_4509
Sponsor: Rep. Foxx, Virginia [R-NC-5]
Process start date: 2023-07-10
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Source data: api.congress.gov
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OFFICIAL LEGAL TITLE

Transparency in Billing Act of 2023

FREQUENTLY ASKED QUESTIONS

What is the official ID of this bill?

The official print number for this legislation is 118_HR_4509.

Which chamber initiated this legislation?

This legislation was initiated in the House of Representatives.

When did the legislative process begin?

The process officially started on 2023-07-10.

What are the main provisions?

Key points include:

  • Hospitals must provide a unique identifier for services rendered at off-campus outpatient departments for claims to be paid.
  • Health insurance plans will not be able to pay claims that do not include the required service location identifier.
  • Patients will not be held liable for services if the hospital fails to meet the identifier requirements.
  • Hospitals can face daily penalties of up to $5,500 for violations, depending on their size.
  • These new rules take effect for plan years beginning on or after January 1, 2024.
What is the specific legal status?

The current status is Expired.

Where can I read the full text of this legislation?

The full official text is available at: View full text

Who is the primary sponsor?

The primary sponsor is Rep. Foxx, Virginia [R-NC-5].

What is the latest detailed status?

The latest detailed status is: Placed on the Union Calendar, Calendar No. 208.

Is this summary verified?

Yes. This content was analyzed by AI and verified by the Lustra Judge System on 2025-12-25.

CATEGORIES

Health