I 
118TH CONGRESS 
1ST SESSION H. R. 6855 
To ensure timely bills for patients. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 19, 2023 
Mr. GALLAGHER introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To ensure timely bills for patients. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Timely Bills for Pa-
tients Act’’. 
SEC. 2. TIMELY BILLS FOR PATIENTS. 
(a) IN GENERAL.— 
(1) AMENDMENT.—Part P of title III of the 
Public Health Service Act (42 U.S.C. 280g et seq.) 
is amended by adding at the end the following: 
‘‘SEC. 399V–7. TIMELY BILLS FOR PATIENTS. 
‘‘(a) IN GENERAL.—The Secretary shall require— 
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‘‘(1) health care facilities, or in the case of 
practitioners providing services outside of such a fa-
cility, practitioners, to provide to patients a list of 
services rendered during the visit to such facility or 
practitioner, and, in the case of a facility, the name 
of the provider for each such service, upon discharge 
or by postal or electronic communication as soon as 
practicable and not later than 5 calendar days after 
discharge; and 
‘‘(2) health care facilities and practitioners to 
send all adjudicated bills to the patient as soon as 
practicable, but not later than 45 calendar days 
after discharge. 
‘‘(b) PAYMENT AFTER BILLING.—No patient may be 
required to pay a bill for health care services any earlier 
than 30 calendar days after receipt of a bill for such serv-
ices. 
‘‘(c) EFFECT OF VIOLATION.— 
‘‘(1) NOTIFICATION
AND
REFUND
REQUIRE-
MENTS.— 
‘‘(A) PROVIDER
LISTS.—If a facility or 
practitioner fails to provide a patient a list as 
required under subsection (a)(1), such facility 
or practitioner shall report such failure to the 
Secretary. 
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‘‘(B) BILLING.—If a facility or practitioner 
bills a patient after the 45-calendar-day period 
described in subsection (a)(2), such facility or 
practitioner shall— 
‘‘(i) report such bill to the Secretary; 
and 
‘‘(ii) refund the patient for the full 
amount paid in response to such bill with 
interest, at a rate determined by the Sec-
retary. 
‘‘(2) CIVIL MONETARY PENALTIES.— 
‘‘(A) IN
GENERAL.—The Secretary may 
impose civil monetary penalties of up to 
$10,000 a day on any facility or practitioner 
that— 
‘‘(i) fails to provide a list required 
under subsection (a)(1) more than 10 
times, beginning on the date of such tenth 
failure; 
‘‘(ii) submits more than 10 bills out-
side of the period described in subsection 
(a)(2), beginning on the date on which 
such facility or practitioner sends the tenth 
such bill; 
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‘‘(iii) fails to report to the Secretary 
any failure to provide lists as required 
under paragraph (1)(A), beginning on the 
date that is 45 calendar days after dis-
charge; or 
‘‘(iv) fails to send any bill as required 
under subsection (a)(2), beginning on the 
date that is 45 calendar days after the 
date of discharge or visit, as applicable. 
‘‘(B) PROCEDURE.—The provisions of sec-
tion 1128A of the Social Security Act, other 
than subsections (a) and (b) and the first sen-
tence of subsection (c)(1) of such section, shall 
apply to civil money penalties under this sub-
section in the same manner as such provisions 
apply to a penalty or proceeding under section 
1128A of the Social Security Act. 
‘‘(3) SAFE HARBOR.—The Secretary may ex-
empt a practitioner or facility from the penalties 
under paragraph (2)(A) or extend the period of time 
specified under subsection (a)(2) for compliance with 
such subsection if a practitioner or facility— 
‘‘(A) makes a good faith attempt to send 
a bill within 30 days but is unable to do so be-
cause of an incorrect address; or 
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‘‘(B) 
experiences 
extenuating 
cir-
cumstances (as defined by the Secretary), such 
as a hurricane or cyberattack, that may reason-
ably delay delivery of a timely bill.’’. 
(2) RULEMAKING.—Not later than 1 year after 
the date of enactment of this Act, the Secretary 
shall promulgate final regulations to define the term 
‘‘extenuating circumstance’’ for purposes of section 
399V–7(c)(3)(B) of the Public Health Service Act, 
as added by paragraph (1). 
(b) GROUP HEALTH PLAN AND HEALTH INSURANCE 
ISSUER REQUIREMENTS.—Subpart II of part A of title 
XXVII of the Public Health Service Act (42 U.S.C. 
300gg–11) is amended by adding to the end the following: 
‘‘SEC. 2729A. TIMELY BILLS FOR PATIENTS. 
‘‘(a) IN GENERAL.—A group health plan or health 
insurance issuer offering group or individual health insur-
ance coverage shall have in place business practices with 
respect to in-network facilities and practitioners to ensure 
that claims are adjudicated in order to facilitate facility 
and practitioner compliance with the requirements under 
section 399V–7(a). 
‘‘(b) CLARIFICATION.—Nothing in subsection (a) pro-
hibits a provider and a group health plan or health insur-
ance issuer from establishing in a contract the timeline 
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for submission by either party to the other party of billing 
information, adjudication, sending of remittance informa-
tion, or any other coordination required between the pro-
vider and the plan or issuer necessary for meeting the 
deadline described in section 399V–7(a)(2).’’. 
(c) EFFECTIVE DATE.—The amendments made by 
subsections (a) and (b) shall take effect 6 months after 
the date of enactment of this Act. 
Æ 
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