,,ib ,union ,calendar ,no4 #feb #aaith ,,congress #b;d ,session ,h4 ,r4 #hfhd ,report ,no4 #aai-gdh ,,in ,,the ,,house ,,of ,,representatives ,may #g1 #bjbf,ms4 ,foxx 7for herself and ,mr4 ,scott of ,virginia7 introduced the following bill2 which was referred to the ,committee on ,education and ,workforce ,july #ac1 #bjbf,reported with an amendment1 committed to the ,committee of the ,whole ,house on the ,state of the ,union1 and ordered to be printed,strike out all after the enacting clause and insert the part printed in italic,for text of introduced bill1 see copy of bill as introduced on ,may #g1 #bjbf ,a ,,bill ,to amend the ,employee ,retirement ,income ,security ,act of #aigd to require group health plans and health insurance issuers offering group health insurance coverage to only pay claims submitted by hospitals that have in place policies and procedures to ensure accurate billing practices1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,transparency in ,billing ,act of #bjbf4 #b4 ,honest billing requirements 7a7 ,in general ,subpart ,b of part #g of subtitle ,b of title ,i of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #aahe et seq47 is amended by adding at the end the following new section3 #gbg4 ,honest billing requirements ,a group health plan or health insurance issuer offering group health insurance coverage may not pay a claim for items and services furnished to an individual at an off-campus outpatient department of a provider 7as defined in section #ija7;c77 submitted by a hospital 7as defined in section #ahfa7;e7 of the ,social ,security ,act7 unless such claim submitted by such hospital includes the separate unique health identifier for the department where items and services were furnished1 in accordance with section #ija4 4 7b7 ,clerical amendment ,the table of contents of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #ajja note7 is amended by adding after the item relating to section #gbf the following3 ,sec4 #gbg4 ,honest billing requirements4 4 7c7 ,effective date ,the amendments made by this section shall take effect with respect to plan years beginning on or after ,january #a1 #bjbg4 #c4 ,regulation of honest billing 7a7 ,in general ,subtitle ,b of title ,i of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #ajba et seq47 is amended by adding at the end the following new part3 #i ,billing ,requirements with ,respect to ,group ,health ,plans and ,coverage #ija4 ,honest billing requirements 7a7 ,in general ,a hospital may not1 with respect to items and services furnished to an individual at an off-campus outpatient department of a provider1 submit a claim for such items and services to a group health plan or health insurance issuer1 and may not hold such individual liable for such items and services1 unless-- 7#a7 such hospital obtains a separate unique health identifier established for such department pursuant to section #aagc7;b7 of the ,social ,security ,act2 and 7#b7 the claim for such items and services includes such separate unique health identifier for such department where such items and services were furnished4 7b7 ,process for reporting suspected violations ,not later than one year after the date of enactment of this section1 the ,secretary shall establish a process under which a suspected violation of this section may be reported to such ,secretary4 7c7 ,off-campus outpatient department of a provider defined ,for purposes of this paragraph1 the term off-campus outpatient department of a provider means a department of a provider 7as defined in section #dac4fe of title #db1 ,code of ,federal ,regulations1 or any successor regulation7 that is not located-- 7#a7 on the campus 7as defined in such section7 of such provider2 or 7#b7 within the distance 7described in such definition of campus7 from a remote location of a hospital facility 7as defined in such section74 4 7b7 ,clerical amendment ,the table of contents of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #ajja note7 is amended by inserting after the item relating to section #hjd the following new item3 ,part #i--;,billing ,requirements with ,respect to ,group ,health ,plans and ,coverage,sec4 #ija4 ,honest billing requirements4 4 #d4 ,enforcement ,section #ejb of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #aacb7 is amended-- 7#a7 in subsection 7a77#f71 by striking or 7#ac7 and inserting 7#ac71 or 7#ad72 and 7#b7 in subsection 7c71 by adding at the end the following new paragraph3 7#ad7 ,secretarial enforcement authority relating to honest billing requirements ,the ,secretary may assess a civil monetary penalty against a hospital for a violation of section #ija in an amount-- 7,a7 in the case of a hospital with not more than #cj beds 7as determined under section #ahj4ij7;c77#b77;ii77,d7 of title #de1 ,code of ,federal ,regulations1 as in effect on the date of the enactment of this paragraph71 not to exceed #cjj per day that the violation is ongoing1 as determined by the ,secretary2 and 7,b7 in the case of a hospital with more than #cj beds 7as so determined71 not to exceed #e1ejj per each such day4 4 #e4 ,implementation ,the ,secretary of ,labor shall implement the amendments made by this ,act by rulemaking4 ,july #ac1 #bjbf,reported with an amendment1 committed to the ,committee of the ,whole ,house on the ,state of the ,union1 and ordered to be printed