As hospitals continue to acquire physician practices and outpatient facilities, services that were previously billed as physician office visits are increasingly being billed as hospital outpatient care. In many cases, patients receive care in the same location from the same providers, but face higher costs because the site has been reclassified as part of a hospital system. These arrangements can lead to additional facility fees, higher reimbursement rates, increased premiums, and greater out-of-pocket costs.

The House Education and Workforce Committee has advanced the bipartisan Transparency in Billing Act of 2026 (H.R. 8684), introduced by Ranking Member Bobby Scott (D-VA) and Representative Virginia Foxx (R-NC). The bill would require hospitals to include a unique identifier when submitting claims for services provided at off-campus hospital outpatient departments, allowing payers to determine where care was delivered and whether hospital-based billing is being applied appropriately.

This added transparency would help employers, health plans, brokers, and consumers identify when higher hospital-based rates may be driving up costs. It would also give brokers and agents clearer information to help clients understand claims, evaluate cost drivers, and make more informed coverage decisions.

NABIP supports the passage of H.R. 8684 because transparent billing is essential to improving affordability, reducing unnecessary spending, and promoting a more accountable private health insurance marketplace.

Contact your Representative today and urge them to support H.R. 8684, the Transparency in Billing Act of 2026.