Us Congress 2023-2024 Regular Session

Us Congress House Bill HB3237

Introduced
5/11/23  
Refer
5/11/23  

Caption

To amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department.

Impact

The implementation of HB 3237 will necessitate changes in how outpatient departments operate, particularly in administrative processes concerning billing and compliance documentation. By requiring unique identifiers, the legislation aims to reduce the potential for misidentification and fraud in billing practices. This could ultimately lead to more accurate reimbursements from Medicare and improved transparency in the services rendered by outpatient departments.

Summary

House Bill 3237 aims to amend Title XVIII of the Social Security Act by instituting a requirement for off-campus outpatient departments of providers to include a unique identifier on claims for items and services. This bill mandates that starting from January 1, 2026, payment for these services will only be made if the provider has obtained this unique identifier and submitted an attestation confirming compliance with specific regulations. The bill is significant for healthcare providers, particularly those with outpatient departments, as it seeks to enhance accountability and streamline claim processing in the Medicare system.

Contention

Points of contention regarding this bill may arise from both healthcare providers and patient advocacy groups. Providers might express concerns about the administrative burden imposed by the requirement to obtain and manage unique identifiers, which could lead to increased operational costs. Additionally, discussions may surface regarding the timeline for compliance, especially the two-year period for attestation submission, which some may argue is inadequate for large healthcare systems. Opponents might voice fears that the complexities added could deter smaller outpatient facilities or negatively impact patient care by complicating service delivery.

Companion Bills

US HB5378

Same As Lower Costs, More Transparency Act

US HB3561

Related PATIENT Act of 2023 Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023

US HB4822

Related Health Care Price Transparency Act of 2023

Previously Filed As

US HB1784

Medicare Fraud Detection and Deterrence Act of 2025This bill requires the Centers for Medicare & Medicaid Services (CMS) to deactivate the standard unique health identifiers of health care providers that are excluded from federal health care programs because of fraud, waste, or abuse.The bill also requires (1) any data submitted by Medicare Advantage plans with respect to durable medical equipment, prosthetics or orthotics, laboratory tests, imaging tests, or home health services to include the standard unique health identifier of the associated provider or supplier; and (2) health care practitioners who are employed by or contract with telehealth companies to use a specialized claims modifier (developed by CMS) for Medicare telehealth services.

US HB4881

To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program.

US HB223

Adoption Information Act This bill requires federally funded family planning programs to provide each person who inquires about their services with specified information about adoption centers in their state. The Department of Health and Human Services must provide the programs with pamphlets containing the required information.

US HB2016

To provide for a limitation on availability of funds for Department of Health and Human Services, Office of the Secretary, General Departmental Maintenance for fiscal year 2024.

US HB8227

To amend title XVIII of the Social Security Act to remove in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology.

US SB1922

A bill to amend title XVIII of the Social Security Act to provide coverage for wigs as durable medical equipment under the Medicare program, and for other purposes.

US HB8108

To amend title XIX of the Social Security Act to add a Medicaid State plan requirement with respect to the determination of residency of certain individuals serving in the Armed Forces.

US HB33

Medicare Dental, Vision, and Hearing Benefit Act of 2023 This bill provides for Medicare coverage of dental, vision, and hearing care. Coverage includes (1) routine dental cleanings and exams, basic and major dental services, emergency dental care, and dentures; (2) routine eye exams, eyeglasses, and contact lenses; and (3) routine hearing exams, hearing aids, and exams for hearing aids. With respect to such care, the bill establishes special payment rules, limitations, and coinsurance requirements.

US HB874

To amend title 38, United States Code, to modify the rate of pay for care or services provided under the Community Care Program of the Department of Veterans Affairs based on the location at which such care or services were provided, and for other purposes.

US HB10291

To amend title XVIII of the Social Security Act to provide coverage for certain fall prevention items under the Medicare program.

Similar Bills

No similar bills found.