What does Preamble of Transparency in Billing Act of 2026 do?

This bill amends the Employee Retirement Income Security Act of 1974. It requires group health plans and health insurance issuers to only pay claims from hospitals with accurate billing policies and procedures.

What does SHORT TITLE. of Transparency in Billing Act of 2026 do?

This bill is formally titled the Transparency in Billing Act of 2026.

What does HONEST BILLING REQUIREMENTS. of Transparency in Billing Act of 2026 do?

This section amends the Employee Retirement Income Security Act of 1974. It establishes honest billing requirements for group health plans and health insurance issuers. Hospitals submitting claims for off-campus outpatient department services must include a separate unique health identifier for the department.

What does REGULATION OF HONEST BILLING. of Transparency in Billing Act of 2026 do?

This section amends the Employee Retirement Income Security Act of 1974 to establish billing requirements for group health plans and health insurance issuers. Hospitals are restricted from submitting claims or holding individuals liable for off-campus outpatient department services unless specific conditions are met. These conditions include obtaining a separate unique health identifier for the department and including that identifier on claims. The Secretary is required to establish a process for reporting suspected violations of these billing requirements within one year of enactment. The term 'off-campus outpatient department of a provider' is defined based on existing regulations.

What does ENFORCEMENT. of Transparency in Billing Act of 2026 do?

This section amends Section 502 of the Employee Retirement Income Security Act of 1974. The amendment modifies subsection (a)(6) to include reference to '(13)'. A new paragraph (13) is added to subsection (c) allowing the Secretary to assess civil monetary penalties against hospitals for violations under section 901. The penalty amount is capped at $300 per day for hospitals with 30 or fewer beds. For hospitals with more than 30 beds, the penalty is capped at $5,500 per day.

What does IMPLEMENTATION. of Transparency in Billing Act of 2026 do?

This section requires the Secretary of Labor to implement the amendments made by this Act through rulemaking.

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Transparency in Billing Act of 2026

Last updated: 5/21/2026 · Introduced: 5/7/2026

Author: Virginia Foxx (R-NC)

TL;DR (AI)

The bill amends ERISA to require group health plans and health insurers to only pay claims from hospitals with accurate billing policies.
Hospitals providing off-campus outpatient services must include a unique health identifier on claims to be eligible for reimbursement.
The Secretary of Labor can impose civil monetary penalties on hospitals for violating the bill's billing requirements, with penalty amounts varying based on hospital bed size.

119th Congressin committeeOfficial page

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Other Sections

Includes provisions on preamble, short title., and 4 more.

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