,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #bdd  ,,9 ,,! ,,h\se ,,(            
,,repres5tatives  ,janu>y #ad1 #bjac    
,ms4 ,s*ak[sky introduc$ ! foll[+ bill2 
:i* 0 ref]r$ to ! ,committee on ,en]gy &
 ,comm]ce  ,a ,,bill  ,to assure t !    
s]vices ( a nonem]g5cy dep>tm5t         
physician are available to hospital     
pati5ts #bd h\rs a day1 sev5 days a week
 9 all non-,f$]al hospitals ) at lea/   
#ajj lic5s$ b$s4  #a4 ,%ort title ,?is  
,act may be cit$ z ! ,physician         
,availability ,act ( #bjac4  #b4        
,requirem5t = physician availability 9  
acute c>e hospitals  7a7 ,9 ,g5]al ,ea* 
cov]$ hospital %all h a qualifi$        
physician available 9 ! hospital #bd    
h\rs a day1 sev5 days a week to att5d to
 ! ne$s ( inpati5ts ( ! hospital4  7b7  
,def9itions ,= purposes ( ?is section3  
7#a7 ,cov]$ hospital  7,a7 ,9 g5]al     
,subject to subp>agraph 7,b71 ! t]m     
cov]$ hospital means a subsection 7d7   
hospital 7z def9$ 9 section             
#ahhf7;d77#a77;,b7 ( ! ,social ,security

 ,act 7#db ,u4,s4,c4                    
#acieww7d77#a77;,b777 t--  7i7 has a    
p>ticipation agreem5t 9 effect "u       
section #ahff ( su* ,act 7#db ,u4,s4,c4 
#acie;cc72  7ii7 is p>ticipat+ 9 !      
program "u title ,,xix ( su* ,act2 or   
7iii7 is receiv+ ,f$]al funds "u a grant
 or coop]ative agreem5t4  7,b7          
,exclusion = f$]al facilities & small   
hospitals ,su* t]m does n include a     
hospital t--  7i7 is a facility ( !     
,f$]al ,gov]nm5t2 or  7ii7 ! ,secret>y (
 ,heal? & ,human ,s]vices det]m9es has  
few] ?an #ajj lic5s$ b$s 7z def9$ by !  
,secret>y74  7#b7 ,physician2 qualifi$  
physician  7,a7 ,! t]m physician means1 
) respect to a hospital1 an individual  
:o is a doctor ( m$ic9e or o/eopa?y     
legally au?oriz$ "u ,/ate law to        
practice m$ic9e & surg]y 9 t hospital4  
7,b7 ,! t]m qualifi$ physician means1 ) 
respect to a hospital1 an individual :o 
is a physician & ^: cr$5tials z su* a   
physician h be5 v]ifi$ by ! adm9i/ration
 ( ! hospital 7be=e provid+ any s]vices 

at ! hospital7 ?r\gh appropriate means1 
includ+ v]ification ?r\gh ! ,national   
,practition] ,databank4  7#c7 ,physician
 availability ,a physician is consid]$  
to be available 9 a hospital if--  7,a7 
! physician is physically pres5t 9 !    
hospital2  7,b7 ! physician's prim>y    
responsibility is to be 9 att5dance to  
s]ve ! ne$s ( ! hospital's inpati5ts )\t
 delay2 &  7,c7 ! physician is n        
physically pres5t 91 assign$ to1 s]v+ 91
 or expect$ to cov]1 ! hospital's       
em]g5cy room or em]g5cy dep>tm5t4  7c7  
,en=cem5t  7#a7 ,w>n+ ,if ! ,secret>y ( 
,heal? & ,human ,s]vices 79 ?is section 
ref]r$ to z ! ,secret>y7 det]m9es t a   
hospital has violat$ subsection 7a71 9 !
 fir/ in/ance ! ,secret>y %all provide a
 writt5 w>n+ reg>d+ su* violation to !  
hospital & %all notify ! ,inspector     
,g5]al ( ! ,dep>tm5t ( ,heal? & ,human  
,s]vices 79 ?is section ref]r$ to z !   
,,hhs ,inspector ,g5]al7 ( su*          
violation4 ,subsequ5tly1 ! ,,hhs        
,inspector ,g5]al %all monitor !        

compliance ( ! hospital ) ! requirem5t (
 subsection 7a74  7#b7 ,second violation
 ,aft] provid+ a w>n+ to a hospital "u  
p>agraph 7#a71 if ! ,secret>y det]m9es t
 ! hospital subsequ5tly & kn[+ly        
violates subsection 7a7--  7,a7 !       
hospital is subject to a civil money    
p5alty 9 an am\nt n to exce$ #ajj1jjj1 &
  7,b7 ! hospital %all submit to ! ,,hhs
 ,inspector ,g5]al1 by n lat] ?an #cj   
days aft] ! date ( su* a det]m9ation1 a 
rem$ial plan to prev5t future violations
 ( ! requirem5t ( su* subsection4  ,!   
provisions ( section #aabh;,a ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#acbj;a-#g;a71 o!r ?an subsections 7a7 &
 7b7 ( su* section1 %all apply to civil 
money p5alties "u subp>agraph 7,a7 9 !  
same mann] z !y apply to a p5alty or    
proce$+ "u subsection 7a7 ( su* section4
  7#c7 ,subsequ5t violations ,aft]      
impos+ a civil money p5alty "u p>agraph 
7#b7 aga9/ a hospital1 if ! ,secret>y   
det]m9es t ! hospital subsequ5tly &     
kn[+ly violates subsection 7a71 !       

,secret>y may issue an ord] disqualify+ 
! hospital f p>ticipation 9 ! programs  
"u titles ,,xviii & ,,xix ( ! ,social   
,security ,act & f receipt ( ,f$]al     
funds "u any grant or coop]ative        
agreem5t = su* p]iod z ! ,secret>y      
specifies & until ! ,secret>y receives  
satisfactory assurances t ! hospital w  
be 9 sub/antial compliance ) !          
requirem5t ( subsection 7a74  7#d7      
,failure to submit or comply ) rem$ial  
plan ,if ! ,secret>y det]m9es1 aft]     
consultation ) ! ,,hhs ,inspector       
,g5]al1 t a hospital has fail$ to submit
 a satisfactory rem$ial plan requir$ "u 
p>agraph 7#b77;,b7 or is fail+ to       
sub/antially c>ry out su* a plan1 !     
,secret>y may susp5d paym5t ( funds to !
 hospital "u titles ,,xviii & ,,xix ( ! 
,social ,security ,act & "u ,f$]al      
grants or coop]ative agreem5ts until !  
,secret>y receives satisfactory         
assurances t su* failures w n cont9ue4  
7d7 ,effective ,date ,?is section %all  
take effect on ! fir/ day ( ! fir/ mon? 

t beg9s m ?an #ahj days aft] ! date ( ! 
enactm5t ( ?is ,act4