Transparency in Billing Act of 2026
Download PDFSponsored by
Rep. Foxx, Virginia [R-NC-5]
ID: F000450
Bill's Journey to Becoming a Law
Track this bill's progress through the legislative process
Latest Action
Ordered to be Reported (Amended) by the Yeas and Nays: 34 - 0.
May 20, 2026
Introduced
📍 Current Status
Next: The bill will be reviewed by relevant committees who will debate, amend, and vote on it.
Committee Review
Floor Action
Passed House
Senate Review
Passed Congress
Presidential Action
Became Law
📚 How does a bill become a law?
1. Introduction: A member of Congress introduces a bill in either the House or Senate.
2. Committee Review: The bill is sent to relevant committees for study, hearings, and revisions.
3. Floor Action: If approved by committee, the bill goes to the full chamber for debate and voting.
4. Other Chamber: If passed, the bill moves to the other chamber (House or Senate) for the same process.
5. Conference: If both chambers pass different versions, a conference committee reconciles the differences.
6. Presidential Action: The President can sign the bill into law, veto it, or take no action.
7. Became Law: If signed (or if Congress overrides a veto), the bill becomes law!
Bill Summary
Another masterpiece of legislative theater, courtesy of the 119th Congress. The "Transparency in Billing Act of 2026" - because who doesn't love a good oxymoron? Let's dissect this farce and uncover the real disease beneath the surface.
**Main Purpose & Objectives:** The bill's stated purpose is to require hospitals to implement "honest billing practices" by obtaining separate unique health identifiers for off-campus outpatient departments. How quaint. In reality, this is just a thinly veiled attempt to appease the insurance lobby and further line the pockets of healthcare administrators.
**Key Provisions & Changes to Existing Law:** The bill amends the Employee Retirement Income Security Act of 1974 to mandate that group health plans and insurers only pay claims from hospitals with "accurate billing practices" in place. It also establishes a process for reporting suspected violations and imposes civil monetary penalties on non-compliant hospitals. Because, you know, fining hospitals is exactly what they need to improve patient care.
**Affected Parties & Stakeholders:** The usual suspects are affected: hospitals, insurance companies, and patients (who will inevitably foot the bill). But let's not forget the real stakeholders - the lobbyists and special interest groups who crafted this legislation to serve their own interests. I'm sure it's just a coincidence that the bill's sponsors, Ms. Foxx and Mr. Scott, have received generous campaign contributions from the healthcare industry.
**Potential Impact & Implications:** This bill will likely lead to increased administrative burdens on hospitals, resulting in higher costs and reduced patient care. The penalties imposed on non-compliant hospitals will be passed on to patients, because that's exactly what they need - more expensive healthcare. Meanwhile, the insurance companies will reap the benefits of "accurate billing practices" by denying more claims and increasing their profits.
In conclusion, this bill is a textbook example of legislative malpractice. It's a cynical attempt to manipulate the system for the benefit of special interests, while pretending to care about transparency and patient welfare. The real disease here is corruption, and this bill is just another symptom of a system that prioritizes greed over people's lives. Now, if you'll excuse me, I have better things to do than watch this farce unfold - like diagnosing the terminal stupidity of our elected officials.
Related Topics
💰 Campaign Finance Network
Rep. Foxx, Virginia [R-NC-5]
Congress 119 • 2024 Election Cycle
No PAC contributions found
No committee contributions found
Cosponsors & Their Campaign Finance
This bill has 1 cosponsors. Below are their top campaign contributors.
Rep. Scott, Robert C. "Bobby" [D-VA-3]
ID: S000185
Top Contributors
0
No contribution data available
Donor Network - Rep. Foxx, Virginia [R-NC-5]
Hub layout: Politicians in center, donors arranged by type in rings around them.
Showing 27 nodes and 27 connections
Total contributions: $81,150
Top Donors - Rep. Foxx, Virginia [R-NC-5]
Showing top 25 donors by contribution amount
Industry Impact
Which industries are materially affected by specific provisions in this bill. 1 helped,1 harmed.
- −Hospitals & Health Systems confidence 0.90
Section 3(a) requires hospitals to obtain a separate unique health identifier for off-campus outpatient departments and include it in claims; noncompliance results in denial of payment and potential civil penalties up to $5,500 per day (Section 4). This imposes administrative and financial costs on hospitals.
- +Health Insurance confidence 0.85
Section 2(a) prohibits group health plans and insurers from paying claims from hospitals lacking the required identifier, reducing improper payments and potentially lowering costs for insurers.
Who funds the sponsor on these industries
For each industry this bill affects, here's what the sponsor (Rep. Foxx, Virginia [R-NC-5]) received from donors associated with that industry during the 2022–present cycles. Donations are not proof of intent — they are a record of who funds the people writing the law.
Industries this bill HARMS
- from 1contribution
- ZIMMERN, SAMUEL H. DR.$500
Project 2025 Policy Matches
This bill shows semantic similarity to the following sections of the Project 2025 policy document. AI-enhanced analysis provides detailed alignment ratings.
Introduction
AI Analysis:
"The Transparency in Billing Act of 2026 aligns with Project 2025's objective of promoting transparency and honesty in medical billing, as well as advancing site neutrality by ensuring accurate billing practices for services provided at off-campus outpatient departments. This alignment is significant as it supports the policy's goal of leveling the playing field among providers and removing financial disabilities for medical professionals."
— 464 — Mandate for Leadership: The Conservative Promise l The Risk Adjustment Data Validation (RADV) rule; l The Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration; and l The Global and Professional Direct Contracting (GPDC, rebranded as the Accountable Care Organization Realizing Equity, Access, and Community Health or ACO REACH) model. Additionally, regulations should advance site neutrality by eliminating the inpa- tient-only list and expanding the ambulatory surgical center covered procedures list. Medicare generally pays more for inpatient hospital procedures and less for the same procedures performed in an outpatient setting. Whether a medical ser- vice is delivered in a physician’s office, a clinic, or a hospital setting, the Medicare payment for that service should be the same. CMS should expand the application of site-neutral payment options to more settings. Such a policy would level the playing field among providers and remove the financial disabilities for medical professionals who would compete with hospital systems.23 Finally, HHS needs to restore and enhance conscience protection regulations that allow medical practitioners to participate in federal health care programs without being compelled to provide sex changes or similar services. LEGISLATIVE PROPOSALS l Remove restrictions on physician-owned hospitals. The Affordable Care Act (ACA)24 imposed restrictions prohibiting Medicare from reimbursing physician-owned and specialty hospitals. The current restrictions do little more than serve the special interests of large hospital systems and undercut consumer choice of high-quality, specialty care. These restrictions should be removed so that physician-owned hospitals can compete with other hospitals in serving Medicare patients.25 l Encourage more direct competition between Medicare Advantage and private plans. Medicare Advantage (MA), a system of competing private health plans, is the major alternative to traditional Medicare for America’s large and growing cohort of seniors. The program provides beneficiaries with a wide range of competitive health plan choices—a richer set of benefits than traditional Medicare provides and at a reasonable cost. Equally as important, the MA program has been registering consistently high marks for superior performance in delivering high-quality care. Critical reforms are still needed to strengthen and improve the program for the future. Specifically: — 465 — Department of Health and Human Services 1. Make Medicare Advantage the default enrollment option. 2. Give beneficiaries direct control of how they spend Medicare dollars. 3. Remove burdensome policies that micromanage MA plans. 4. Replace the complex formula-based payment model with a competitive bidding model. 5. Reconfigure the current risk adjustment model. 6. Remove restrictions on key benefits and services, including those related to prescription drugs, hospice care, and medical savings account plans.26 Legacy Medicare Reform. Legislation reforming legacy (non-MA) Medicare should: l Base payments on the health status of the patient or intensity of the service rather than where the patient happens to receive that service. l Replace the bureaucrat-driven fee-for-service system with value- based payments to empower patients to find the care that best serves their needs. l Codify price transparency regulations. l Restructure 340B drug subsidies27 toward beneficiaries rather than hospitals. l Repeal harmful health policies enacted under the Obama and Biden Administrations such as the Medicare Shared Savings Program28 and Inflation Reduction Act.29 Medicare Part D Reform. The Inflation Reduction Act (IRA) created a drug price negotiation program in Medicare that replaced the existing private-sector negotiations in Part D with government price controls for prescription drugs. These government price controls will limit access to medications and reduce patient access to new medication. This “negotiation” program should be repealed, and reforms in Part D that will have meaningful impact for seniors should be pursued. Other reforms should include eliminating the coverage gap in Part D, reducing the government share in
Introduction
AI Analysis:
"The Transparency in Billing Act of 2026 aligns moderately with the Project 2025 policy by promoting transparency and honesty in medical billing, which indirectly supports the goal of advancing site neutrality and reducing financial disparities among healthcare providers. However, it does not directly address key aspects of the Project 2025 policy such as removing restrictions on physician-owned hospitals or expanding site-neutral payment options."
— 464 — Mandate for Leadership: The Conservative Promise l The Risk Adjustment Data Validation (RADV) rule; l The Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration; and l The Global and Professional Direct Contracting (GPDC, rebranded as the Accountable Care Organization Realizing Equity, Access, and Community Health or ACO REACH) model. Additionally, regulations should advance site neutrality by eliminating the inpa- tient-only list and expanding the ambulatory surgical center covered procedures list. Medicare generally pays more for inpatient hospital procedures and less for the same procedures performed in an outpatient setting. Whether a medical ser- vice is delivered in a physician’s office, a clinic, or a hospital setting, the Medicare payment for that service should be the same. CMS should expand the application of site-neutral payment options to more settings. Such a policy would level the playing field among providers and remove the financial disabilities for medical professionals who would compete with hospital systems.23 Finally, HHS needs to restore and enhance conscience protection regulations that allow medical practitioners to participate in federal health care programs without being compelled to provide sex changes or similar services. LEGISLATIVE PROPOSALS l Remove restrictions on physician-owned hospitals. The Affordable Care Act (ACA)24 imposed restrictions prohibiting Medicare from reimbursing physician-owned and specialty hospitals. The current restrictions do little more than serve the special interests of large hospital systems and undercut consumer choice of high-quality, specialty care. These restrictions should be removed so that physician-owned hospitals can compete with other hospitals in serving Medicare patients.25 l Encourage more direct competition between Medicare Advantage and private plans. Medicare Advantage (MA), a system of competing private health plans, is the major alternative to traditional Medicare for America’s large and growing cohort of seniors. The program provides beneficiaries with a wide range of competitive health plan choices—a richer set of benefits than traditional Medicare provides and at a reasonable cost. Equally as important, the MA program has been registering consistently high marks for superior performance in delivering high-quality care. Critical reforms are still needed to strengthen and improve the program for the future. Specifically:
Introduction
AI Analysis:
"The bill's focus on hospital price transparency and accurate billing practices aligns moderately with Project 2025's objective to strengthen hospital price transparency, although the bill's approach and motivations are criticized as serving special interests rather than consumer welfare. The alignment is not strong due to the bill's potential to increase administrative burdens and costs."
— 470 — Mandate for Leadership: The Conservative Promise from the subsidized market, giving the non-subsidized market regulatory relief from the costly ACA regulatory mandates.39 l Strengthen hospital price transparency. In 2020, CMS completed its rule to require hospitals to post the prices of common hospital procedures.40 Future updates of these rules should focus on including quality measures. Combined with the shared savings models and other consumer tools, these efforts could deliver considerable savings for consumers.41 Center for Consumer Information and Insurance Oversight (CCHO). CMS also plays an outsized role in overseeing the Obamacare exchanges, includ- ing managing Healthcare.gov, through the Center for Consumer Information and Insurance Oversight (CCIIO). While Obamacare limits plan options, CCIIO has been overly prescriptive in dictating what benefits and types of health plans may participate in the exchanges, thereby actually stifling market innovation and driv- ing up costs. Congress should build on the Trump Administration’s efforts to expand choices for small businesses and workers, both in and out of the exchanges, by codifying an expansion of association health plans, short-term health plans, and health reim- bursement arrangements (including individual coverage HRAs). CCIIO should also work with the Treasury Department and the Office of Management and Budget (OMB) to give consumers more flexibility with their health care dollars through expanded access to health savings accounts. EMERGENCY PREPAREDNESS l Expand the scope of practice of low-complexity and moderate- complexity clinical laboratories. During the COVID-19 pandemic, allowing laboratories greater regulatory flexibility regarding CLIA requirements increased access to testing. However, the need for regulatory flexibility is not limited to emergency situations. Ongoing innovations in medical care will continue to drive demand for clinical testing and new tests. One way that increasing demand for other medical services has been accommodated is by revising restrictions on scope of practice to enable providers to practice at the so-called top of their license. CMS should similarly revise CLIA rules regarding scope of practice for clinical laboratories and testing personnel.42 l Create CLIA-certification-equivalent pathways for non-clinical laboratories and researchers. The COVID-19 pandemic revealed that the U.S. needs to leverage the expertise of non-clinical laboratories and researchers in order to bolster clinical testing capacity. To accomplish this,
Showing 3 of 4 policy matches
About These Correlations
Policy matches are calculated using a hybrid approach: initial candidates are found using semantic similarity between bill summaries and Project 2025 policy text, then an AI model (Llama 3.1 70B) provides detailed alignment ratings and analysis. Ratings range from 1 (minimal alignment) to 5 (very strong alignment). This analysis does not imply direct causation or intent.