Fair Telehealth Billing Act of 2026

Summary of HR 9431 (119th Congress)

Purpose and intent

HR 9431 seeks to amend the Employee Retirement Income Security Act of 1974 (ERISA) to prohibit health care providers and facilities from imposing certain facility fees for telehealth services. The bill targets the practice of charging facility fees for telehealth visits, aiming to ensure that telehealth encounters are not subject to extra facility charges that can increase patient costs or create financial barriers to access.

Key provisions and changes

• Amends ERISA: The bill adds a prohibition related to facility fees when telehealth services are provided.
• Prohibited charges: Health care providers and facilities would be barred from imposing facility fees specifically for telehealth encounters. This is intended to prevent patients from being billed higher (or separate) facility-related charges solely due to the modality of care (telehealth) rather than in-person visits.
• Scope and applicability: The prohibition is framed within the context of ERISA-regulated health plans and would apply to entities subject to ERISA. This includes group health plans and health insurance issuers administering those plans.
• Compliance and enforcement: While the text provided does not detail procedural enforcement, typical ERISA-related enforcement would involve plan fiduciaries, regulators, or applicable enforcement mechanisms to ensure compliance and address violations.

Affected parties

• Patients enrolled in ERISA-covered health plans, especially those using telehealth services.
• Health care providers and facilities that bill telehealth encounters, who would need to avoid or modify facility fee charging practices to comply.
• Employers and plan sponsors offering ERISA-governed health benefits, who administer or fund these plans and must ensure their arrangements and network contracts are compliant.
• Insurance issuers and third-party administrators servicing ERISA plans, who would need to align billing practices with the prohibition.

Procedural and timeline aspects

• Introduction and referral: The bill was introduced in the House and referred to the House Committee on Education and Workforce on June 24, 2026.
• Sponsorship: Co-sponsor listed is Jahana Hayes.
• Next steps (typical for such bills): Committee review, potential markups, consideration on the floor, and, if passed, transmission to the Senate for consideration. Specific deadlines or legislative timelines would be determined during committee proceedings and overall floor action.

Potential impact and considerations

• Consumer cost relief: If enacted, patients on ERISA plans could experience lower out-of-pocket costs for telehealth by avoiding additional facility charges.
• Telehealth access: By reducing financial barriers associated with telehealth, the bill could promote broader use of remote care.
• Administrative changes: Providers and facilities would need to adjust billing practices to ensure compliance, potentially affecting revenue streams tied to facility fees.
• Regulatory alignment: The bill would add a specific ERISA-related prohibition to the legal framework governing health plan billing practices, potentially intersecting with state telehealth regulations and existing payer contracts.

Note: The summary reflects the publicly available information on the bill’s title, stated purpose, and action history. For precise language, definitions (e.g., what constitutes a “facility fee” or “telehealth encounter”), enforcement mechanisms, and any applicable exclusions or exceptions, the bill’s text as filed and any committee reports should be consulted.