,,ii  #aac? ,,congress  #a/ ,session    
,s4 #cbh  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,febru>y #ad1 #bjac    
,mr4 ,?une 7= himself1 ,mr4 ,udall (    
,new ,mexico1 & ,mr4 ,b5net7 introduc$ !
 foll[+ bill2 :i* 0 read twice & ref]r$ 
to ! ,committee on ,f9ance  ,a ,,bill   
,to am5d title ,,xviii ( ! ,social      
,security ,act to all[ c]ta9 critical   
access hospitals & sole community       
hospitals to use int]active             
telecommunications sy/ems to satisfy    
requirem5ts ) respect to hav+ a         
physician available to /abilize an      
individual ) an em]g5cy m$ical condition
 "u ! ,m$ic>e program4  #a4 ,%ort title 
,?is ,act may be cit$ z ! ,/r5g!n+      
,rural ,access to ,em]g5cy ,s]vices     
,act4  #b4 ,all[+ c]ta9 critical access 
hospitals & sole community hospitals to 
use int]active telecommunications sy/ems
 to satisfy requirem5ts ) respect to    
hav+ a physician available to /abilize  
an individual ) an em]g5cy m$ical       
condition  7a7 ,9 g5]al ,section        

#ahff7;a7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acie;cc7a77 is am5d$--  
7#a7 9 p>agraph 7#a77;,i77iii71 by      
ins]t+ 7subject to p>agraph 7#d77 aft]  
on call = duty2 &  7#b7 by add+ at ! end
 ! foll[+ new p>agraph3  7#d7 7,a7 ,=   
purposes ( p>agraph 7#a77;,i77iii7 ( ?is
 subsection & subsections 7b77#a77;,a7 &
 7d77#a77;,c7 ( section #ahfg1 effective
 on ! date ( enactm5t ( ?is p>agraph1 ) 
respect to an applicable critical access
 hospital or applicable sole community  
hospital1 a physician is consid]$ on    
call = duty "u su* p>agraph1 available  
to provide fur!r m$ical exam9ation &    
treatm5t necess>y to /abilize an        
individual ) an em]g5cy m$ical condition
 "u su* subsection 7b77#a77;,a71 & to h 
appe>$ "u su* subsection 7d77#a77;,c71  
if ! physician is available--  7i7 9    
p]son2 or  7ii7 subject to subp>agraph  
7,b71 by int]active telecommunications  
sy/em 7z def9$ 9 section #daj4gh7;a77#c7
 ( title #db1 ,code ( ,f$]al            
,regulations74  7,b7 ,subp>agraph       

7,a77ii7 %all only apply if--  7i7 !    
physician available by su* int]active   
telecommunications sy/em is bo>d c]tifi$
 9 em]g5cy m$ic9e or p$iatric em]g5cy   
m$ic9e2 &  7ii7 a nurse practition] or  
physician assi/ant 7z ^? t]ms are def9$ 
9 section #ahfa7;aa77#e77 is onsite 9 ! 
em]g5cy dep>tm5t4  7,c7 ,9 ?is p>agraph3
  7i7 ,! t]m applicable critical access 
hospital means a critical access        
hospital 7z def9$ 9 section             
#ahfa7mm77#a77 locat$--  7,i7 9 an area 
t is designat$ z a rural heal?          
pr(essional %ortage area "u section     
#ccb7;a77#a77;,a7 ( ! ,public ,heal?    
,s]vice ,act2 &  7,,ii7 9 a c\nty t is n
 includ$ 9 a ,metropolitan ,/ati/ical   
area4  7ii7 ,! t]m applicable sole      
community hospital means a sole         
community hospital 7z def9$ 9 section   
#ahhf7;d77#e77;,d77iii77 t--  7,i7 has  
less ?an #ej b$s2  7,,ii7 has an em]g5cy
 dep>tm5t2 &  7,,iii7 is locat$--  7aa7 
9 an area t is designat$ z a rural heal?
 pr(essional %ortage area "u section    

#ccb7;a77#a77;,a7 ( ! ,public ,heal?    
,s]vice ,act2 &  7bb7 9 a c\nty t is n  
includ$ 9 a ,metropolitan ,/ati/ical    
,area4  4  7b7 ,con=m+ am5dm5ts ,section
 #ahfg ( ! ,social ,security ,act 7#db  
,u4,s4,c4 #acie;dd7 is am5d$--  7#a7 9  
subsection 7b77#a77;,a71 by ins]t+      
7det]m9$ 9 accordance ) section         
#ahff7;a77#d77 aft] hospital2 &  7#b7 9 
subsection 7d77#a77;,c71 9 ! fir/       
s5t5ce1 by ins]t+ 7det]m9$ 9 accordance 
) section #ahff7;a77#d77 aft] refuses to
 appe>4