H.R. 8684 — Transparency in Billing Act of 2026

This section prohibits a group health plan or health insurance issuer from paying a claim for items and services furnished at an off-campus outpatient department of a provider unless the claim includes the separate unique health identifier for that department. The prohibition applies to plan years beginning on or after January 1, 2027.

This section imposes honest billing requirements on hospitals regarding items and services furnished at off-campus outpatient departments of providers. A hospital may not submit a claim to a group health plan or health insurance issuer, or hold an individual liable, unless the department obtains a separate unique health identifier under section 1173(b) of the Social Security Act and includes that identifier on the claim. The Secretary must establish a process for reporting suspected violations no later than one year after enactment.

This section authorizes the Secretary to assess civil monetary penalties against hospitals for violations of honest billing requirements, not to exceed $300 per day for hospitals with 30 or fewer beds and $5,500 per day for hospitals with more than 30 beds, and empowers the Secretary to bring civil actions to collect such penalties.