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

This section establishes honest billing requirements under the Employee Retirement Income Security Act of 1974 by prohibiting a group health plan or health insurance issuer offering group health insurance coverage from paying a claim for items and services furnished to an individual at an off-campus outpatient department of a provider unless the claim includes the separate unique health identifier for that department. The requirements apply to plan years beginning on or after January 1, 2027.

This section adds a new Part 9 to Subtitle B of Title I of the Employee Retirement Income Security Act of 1974 establishing honest billing requirements for hospitals. It prohibits a hospital from submitting a claim to a group health plan or health insurance issuer, or holding an individual liable, for items and services furnished at an off-campus outpatient department of a provider unless the hospital obtains a separate unique health identifier for the department under section 1173(b) of the Social Security Act and includes that identifier on the claim. This section also requires the Secretary to establish a process for reporting suspected violations within one year of enactment and defines an off-campus outpatient department of a provider by reference to existing regulations under 42 C.F.R. § 413.65.

This section authorizes the Secretary to assess civil monetary penalties against hospitals for violations of section 901. Penalties may not exceed $300 per day for hospitals with 30 or fewer beds (as determined under 45 C.F.R. 180.90(c)(2)(ii)(D)) and $5,500 per day for hospitals with more than 30 beds.