Preventing Hospital Overbilling of Medicare Act

HR 2863, the Preventing Hospital Overbilling of Medicare Act, requires hospitals with off-campus outpatient departments (clinics not on the main hospital campus) to bill Medicare using a separate unique identifier for those locations starting January 1, 2024. It eliminates exceptions that previously allowed hospitals to bill higher rates for services provided at these off-campus sites, mandating that all claims for such services use specific billing formats (HIPAA 837P or CMS 1500) with the new identifier. This directly affects hospitals operating off-campus clinics that serve Medicare patients, ensuring they cannot overbill Medicare by misclassifying these locations as on-campus services. The bill standardizes billing practices to prevent inaccurate charges and aligns with existing Medicare payment rules for off-campus care.