,i  #aacth ,,congress  #b;d ,session    
,h4 ,r4 #ebcb  ,,in ,,the ,,house ,,of  
,,representatives  ,july #bi1 #bjad ,mr4
 ,doggett 7for himself and ,mr4 ,young  
of ,indiana7 introduced the following   
bill2 which was referred to the         
,committee on ,ways and ,means1 and in  
addition to the ,committee on ,energy   
and ,commerce1 for a period to be       
subsequently determined by the ,speaker1
 in each case for consideration of such 
provisions as fall within the           
jurisdiction of the committee concerned 
,a ,,bill  ,to amend title ,,xviii of   
the ,social ,security ,act to require   
hospitals to provide certain            
notifications to individuals classified 
by such hospitals under observation     
status rather than admitted as          
inpatients of such hospitals4  #a4      
,short title ,this ,act may be cited as 
the ,notice of ,observation ,treatment  
and ,implication for ,care ,eligibility 
,act or the ,,notice ,act4  #b4         
,medicare requirement for hospital      

notifications of observation status  7a7
 ,in general ,section #ahff7;a77#a7 of  
the ,social ,security ,act 7#db         
,u4,s4,c4 #acie;cc7a77#a77 is amended-- 
7#a7 in subparagraph 7,v71 by striking  
at the end and2  7#b7 in the first      
subparagraph 7,w71 by striking at the   
end the period and inserting a comma2   
7#c7 in the second subparagraph 7,w7--  
7,a7 by redesignating such subparagraph 
as subparagraph 7,x72 and  7,b7 by      
striking at the end the period and      
inserting 1 and2 and  7#d7 by inserting 
after such subparagraph 7,x7 the        
following new subparagraph3  7,y7 in the
 case of a hospital1 to provide to each 
individual who is entitled to benefits  
under part ,a and who the hospital      
classifies for more than #bd hours as an
 outpatient under observation status or 
any other similar status1 as the        
,secretary determines appropriate 7or to
 a person acting on the individual's    
behalf71 not later than #cf hours after 
the time of such classification of such 

individual under such status 7or1 if    
sooner1 upon discharge71 an adequate    
oral and written notification 7as       
defined by the ,secretary pursuant to   
rulemaking and containing such language 
as the ,secretary prescribes consistent 
with this paragraph7 which--  7i7       
explains the status of the individual as
 an outpatient under such observation   
status or any other such similar status 
and not as an inpatient of the hospital2
  7ii7 explains the reason for the      
classification of such individual under 
such status2  7iii7 explains the        
implications of such status as an       
outpatient on--  7,i7 eligibility for   
coverage of items and services under    
this title1 including such items and    
services furnished by the hospital with 
respect to such individual while under  
such status and for items and services  
under this title for a subsequent       
discharge to a skilled nursing facility 
or other facility2 and  7,,ii7          
cost-sharing requirements under this    

title1 including with respect to items  
and services furnished by the hospital  
to such individual while under such     
status and with respect to items and    
services under this title for a         
subsequent discharge to a skilled       
nursing facility or other facility2     
7iv7 includes the name and title of the 
staff of the hospital who provided the  
oral notification and the date and time 
of such oral notification2  7v7 includes
 such additional information as the     
,secretary deems appropriate2 and  7vi7 
in the case of the written notification1
 is--  7,i7 signed by such individual   
7or person acting on the individual's   
behalf7 to acknowledge receipt of such  
notification2  7,,ii7 written and       
formatted using language that is clear  
and easily understandable to ,medicare  
beneficiaries2 and  7,,iii7 made        
available in different languages1 as    
specified by the ,secretary4  4  7b7    
,effective date ,the amendments made by 
subsection 7a7 shall apply with respect 

to items and services furnished on or   
after the date that is six months after 
the date of the enactment of this ,act4