,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #bdd  ,,in ,,the ,,house ,,of   
,,representatives  ,january #ad1 #bjac  
,ms4 ,schakowsky introduced the         
following bill2 which was referred to   
the ,committee on ,energy and ,commerce 
,a ,,bill  ,to assure that the services 
of a nonemergency department physician  
are available to hospital patients #bd  
hours a day1 seven days a week in all   
non-,federal hospitals with at least    
#ajj licensed beds4  #a4 ,short title   
,this ,act may be cited as the          
,physician ,availability ,act of #bjac4 
#b4 ,requirement for physician          
availability in acute care hospitals    
7a7 ,in ,general ,each covered hospital 
shall have a qualified physician        
available in the hospital #bd hours a   
day1 seven days a week to attend to the 
needs of inpatients of the hospital4    
7b7 ,definitions ,for purposes of this  
section3  7#a7 ,covered hospital  7,a7  
,in general ,subject to subparagraph    
7,b71 the term covered hospital means a 

subsection 7d7 hospital 7as defined in  
section #ahhf7;d77#a77;,b7 of the       
,social ,security ,act 7#db ,u4,s4,c4   
#acieww7d77#a77;,b777 that--  7i7 has a 
participation agreement in effect under 
section #ahff of such ,act 7#db         
,u4,s4,c4 #acie;cc72  7ii7 is           
participating in the program under title
 ,,xix of such ,act2 or  7iii7 is       
receiving ,federal funds under a grant  
or cooperative agreement4  7,b7         
,exclusion for federal facilities and   
small hospitals ,such term does not     
include a hospital that--  7i7 is a     
facility of the ,federal ,government2 or
  7ii7 the ,secretary of ,health and    
,human ,services determines has fewer   
than #ajj licensed beds 7as defined by  
the ,secretary74  7#b7 ,physician2      
qualified physician  7,a7 ,the term     
physician means1 with respect to a      
hospital1 an individual who is a doctor 
of medicine or osteopathy legally       
authorized under ,state law to practice 
medicine and surgery in that hospital4  

7,b7 ,the term qualified physician      
means1 with respect to a hospital1 an   
individual who is a physician and whose 
credentials as such a physician have    
been verified by the administration of  
the hospital 7before providing any      
services at the hospital7 through       
appropriate means1 including            
verification through the ,national      
,practitioner ,databank4  7#c7          
,physician availability ,a physician is 
considered to be available in a hospital
 if--  7,a7 the physician is physically 
present in the hospital2  7,b7 the      
physician's primary responsibility is to
 be in attendance to serve the needs of 
the hospital's inpatients without delay2
 and  7,c7 the physician is not         
physically present in1 assigned to1     
serving in1 or expected to cover1 the   
hospital's emergency room or emergency  
department4  7c7 ,enforcement  7#a7     
,warning ,if the ,secretary of ,health  
and ,human ,services 7in this section   
referred to as the ,secretary7          

determines that a hospital has violated 
subsection 7a71 in the first instance   
the ,secretary shall provide a written  
warning regarding such violation to the 
hospital and shall notify the ,inspector
 ,general of the ,department of ,health 
and ,human ,services 7in this section   
referred to as the ,,hhs ,inspector     
,general7 of such violation4            
,subsequently1 the ,,hhs ,inspector     
,general shall monitor the compliance of
 the hospital with the requirement of   
subsection 7a74  7#b7 ,second violation 
,after providing a warning to a hospital
 under paragraph 7#a71 if the ,secretary
 determines that the hospital           
subsequently and knowingly violates     
subsection 7a7--  7,a7 the hospital is  
subject to a civil money penalty in an  
amount not to exceed #ajj1jjj1 and  7,b7
 the hospital shall submit to the ,,hhs 
,inspector ,general1 by not later than  
#cj days after the date of such a       
determination1 a remedial plan to       
prevent future violations of the        

requirement of such subsection4  ,the   
provisions of section #aabh;,a of the   
,social ,security ,act 7#db ,u4,s4,c4   
#acbj;a-#g;a71 other than subsections   
7a7 and 7b7 of such section1 shall apply
 to civil money penalties under         
subparagraph 7,a7 in the same manner as 
they apply to a penalty or proceeding   
under subsection 7a7 of such section4   
7#c7 ,subsequent violations ,after      
imposing a civil money penalty under    
paragraph 7#b7 against a hospital1 if   
the ,secretary determines that the      
hospital subsequently and knowingly     
violates subsection 7a71 the ,secretary 
may issue an order disqualifying the    
hospital from participation in the      
programs under titles ,,xviii and ,,xix 
of the ,social ,security ,act and from  
receipt of ,federal funds under any     
grant or cooperative agreement for such 
period as the ,secretary specifies and  
until the ,secretary receives           
satisfactory assurances that the        
hospital will be in substantial         

compliance with the requirement of      
subsection 7a74  7#d7 ,failure to submit
 or comply with remedial plan ,if the   
,secretary determines1 after            
consultation with the ,,hhs ,inspector  
,general1 that a hospital has failed to 
submit a satisfactory remedial plan     
required under paragraph 7#b77;,b7 or is
 failing to substantially carry out such
 a plan1 the ,secretary may suspend     
payment of funds to the hospital under  
titles ,,xviii and ,,xix of the ,social 
,security ,act and under ,federal grants
 or cooperative agreements until the    
,secretary receives satisfactory        
assurances that such failures will not  
continue4  7d7 ,effective ,date ,this   
section shall take effect on the first  
day of the first month that begins more 
than #ahj days after the date of the    
enactment of this ,act4