I 
118TH CONGRESS 
1ST SESSION H. R. 3417 
To ensure fair billing practices for items and services furnished by off- 
campus outpatient departments of a provider. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 17, 2023 
Mr. HERN (for himself and Ms. KUSTER) introduced the following bill; which 
was referred to the Committee on Energy and Commerce, and in addition 
to the Committee on Ways and Means, for a period to be subsequently 
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To ensure fair billing practices for items and services fur-
nished by off-campus outpatient departments of a pro-
vider. 
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 ‘‘Facilitating Account-
ability In Reimbursements Act’’ or the ‘‘FAIR Act’’. 
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SEC. 2. ENSURING FAIR BILLING PRACTICES FOR ITEMS 
AND SERVICES FURNISHED BY OFF-CAMPUS 
OUTPATIENT DEPARTMENTS OF A PROVIDER. 
(a) SEPARATE NPIS FOR OFF-CAMPUS OUTPATIENT 
DEPARTMENTS OF A PROVIDER.— 
(1) IN GENERAL.—Section 1173(b) of the So-
cial Security Act (42 U.S.C. 1320d–2(b)) is amend-
ed by adding at the end the following new para-
graph: 
‘‘(3) ENSURING SEPARATE NPIS FOR OFF-CAM-
PUS OUTPATIENT DEPARTMENTS OF A PROVIDER.— 
The standards specified under paragraph (1) shall 
ensure that, not later than January 1, 2025, each 
off-campus outpatient department of a provider (as 
defined in section 1833(t)(21)(B)) is assigned a sep-
arate unique health identifier from such provider.’’. 
(2) TREATMENT OF CERTAIN DEPARTMENTS AS 
SUBPARTS OF A HOSPITAL.—Not later than January 
1, 2025, the Secretary of Health and Human Serv-
ices shall revise sections 162.408 and 162.410 of 
title 45, Code of Federal Regulations, to ensure that 
each off-campus outpatient department of a provider 
(as defined in section 1833(t)(21)(B) of the Social 
Security Act (42 U.S.C. 1395l(t)(21)(B))) is treated 
as a subpart (as described in such sections) of such 
provider and assigned a unique health identifier pur-
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suant to section 1173(b)(3) of such Act (as added 
by paragraph (1)). 
(b) OFF-CAMPUS DEPARTMENTS
OF
A PROVIDER 
BILLING REQUIREMENTS.— 
(1) MEDICARE.— 
(A) IN GENERAL.—Section 1866(a)(1) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395cc(a)(1)) is amended— 
(i) in subparagraph (X), by striking 
‘‘and’’ at the end; 
(ii) in subparagraph (Y)(ii)(V), by 
striking the period and inserting ‘‘, and’’; 
and 
(iii) by inserting after subparagraph 
(Y) the following new subparagraph: 
‘‘(Z) in the case of a hospital with an off-cam-
pus outpatient department of a provider (as defined 
in section 1833(t)(21)(B)), with respect to items 
and services furnished at such department of a pro-
vider on or after January 1, 2025, to bill under this 
title (including under part C of this title) for such 
items and services using the unique health identifier 
established for such department of a provider pursu-
ant to section 1173(b)(3) on a HIPAA X12 837P 
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