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.

I 118TH CONGRESS 1ST SESSION H. R. 3237 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. IN THE HOUSE OF REPRESENTATIVES MAY 11, 2023 Mr. JOYCE of Pennsylvania (for himself and Mr. SARBANES) introduced the following bill; which was referred to the Committee on Energy and Com- merce, and in addition to the Committee on Ways and Means, for a pe- riod to be subsequently determined by the Speaker, in each case for con- sideration of such provisions as fall within the jurisdiction of the com- mittee concerned A BILL 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 serv- ices, and to require providers with a department of a provider to submit to the Centers for Medicare & Med- icaid Services an attestation with respect to each such department. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 04:30 May 24, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3237.IH H3237 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 3237 IH SECTION 1. REQUIRING A SEPARATE IDENTIFICATION 1 NUMBER AND AN ATTESTATION FOR EACH 2 OFF-CAMPUS OUTPATIENT DEPARTMENT OF 3 A PROVIDER. 4 Section 1833(t) of the Social Security Act (42 U.S.C. 5 1395l(t)) is amended by adding at the end the following 6 new paragraph: 7 ‘‘(23) USE OF UNIQUE HEALTH IDENTIFIERS; 8 ATTESTATION.— 9 ‘‘(A) IN GENERAL.—No payment may be 10 made under this subsection (or under an appli- 11 cable payment system pursuant to paragraph 12 (21)) for items and services furnished on or 13 after January 1, 2026, by an off-campus out- 14 patient department of a provider (as defined in 15 subparagraph (C)) unless— 16 ‘‘(i) such department has obtained, 17 and such items and services are billed 18 under, a unique health identifier (as estab- 19 lished pursuant to standards described in 20 section 1173(b)) that is separate from 21 such identifier for such provider; and 22 ‘‘(ii) such provider has submitted to 23 the Secretary, during the 2-year period 24 ending on the date such items and services 25 are so furnished, an attestation that such 26 VerDate Sep 11 2014 04:30 May 24, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3237.IH H3237 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 3237 IH department is compliant with the require- 1 ments described in section 413.65 of title 2 42, Code of Federal Regulations (or a suc- 3 cessor regulation). 4 ‘‘(B) PROCESS FOR SUBMISSION AND RE- 5 VIEW.—Not later than 1 year after the date of 6 enactment of this paragraph, the Secretary 7 shall, through notice and comment rulemaking, 8 establish a process for each provider with an 9 off-campus outpatient department of a provider 10 to submit an attestation pursuant to subpara- 11 graph (A)(ii), and for the Secretary to review 12 each such attestation and determine, through 13 site visits or through remote audits (as deter- 14 mined appropriate by the Secretary), whether 15 such department is compliant with the require- 16 ments described in such subparagraph. 17 ‘‘(C) OFF-CAMPUS OUTPATIENT DEPART- 18 MENT OF A PROVIDER DEFINED.—For purposes 19 of this paragraph, the term ‘off-campus out- 20 patient department of a provider’ means a de- 21 partment of a provider (as defined in section 22 413.65 of title 42, Code of Federal Regulations, 23 or any successor regulation) that is not lo- 24 cated— 25 VerDate Sep 11 2014 04:30 May 24, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3237.IH H3237 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 3237 IH ‘‘(i) on the campus (as defined in such 1 section) of such provider; or 2 ‘‘(ii) within the distance (described in 3 such definition of campus) from a remote 4 location of a hospital facility (as defined in 5 such section).’’. 6 Æ VerDate Sep 11 2014 04:30 May 24, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6301 E:\BILLS\H3237.IH H3237 kjohnson on DSK79L0C42PROD with BILLS