[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6855 Introduced in House (IH)]
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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 Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Timely Bills for Patients 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--
``(1) health care facilities, or in the case of
practitioners providing services outside of such a facility,
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 services.
``(c) Effect of Violation.--
``(1) Notification and refund requirements.--
``(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.
``(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
Secretary.
``(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 outside
of the period described in subsection (a)(2),
beginning on the date on which such facility or
practitioner sends the tenth such bill;
``(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 discharge; 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 section 1128A
of the Social Security Act, other than subsections (a)
and (b) and the first sentence of subsection (c)(1) of
such section, shall apply to civil money penalties
under this subsection 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 exempt 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 because of an
incorrect address; or
``(B) experiences extenuating circumstances (as
defined by the Secretary), such as a hurricane or
cyberattack, that may reasonably 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 insurance 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) prohibits a
provider and a group health plan or health insurance issuer from
establishing in a contract the timeline for submission by either party
to the other party of billing information, adjudication, sending of
remittance information, or any other coordination required between the
provider 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.
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