,,ii  #aad? ,,congress  #a/ ,session    
,s4 #acdi  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,may #ad1 #bjae,mr4    
,c>d9 7= himself & ,mr4 ,enzi7 introduc$
 ! foll[+ bill2 :i* 0 read twice &      
ref]r$ to ! ,committee on ,f9ance  ,a   
,,bill  ,to am5d title ,,xviii ( !      
,social ,security ,act to require       
hospitals to provide c]ta9 notifications
 to individuals classifi$ by su*        
hospitals "u obs]vation /atus r ?an     
admitt$ z inpati5ts ( su* hospitals4    
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,notice ( ,obs]vation ,treatm5t &     
,implication = ,c>e ,eligibility ,act or
 ! ,,notice ,act4  #b4 ,m$ic>e          
requirem5t = hospital notifications (   
obs]vation /atus ,section #ahff7;a77#a7 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #acie;cc7a77#a77 is am5d$--   
7#a7 9 subp>agraph 7,v71 by /rik+ at !  
end &2  7#b7 9 ! fir/ subp>agraph 7,w71 
by /rik+ at ! end ! p]iod & ins]t+ a    
comma2  7#c7 9 ! second subp>agraph     
7,w7-- 7,a7 by r$esignat+ su*           

subp>agraph z subp>agraph 7,x72 &  7,b7 
by /rik+ at ! end ! p]iod & ins]t+ 1 &2 
&  7#d7 by ins]t+ aft] su* subp>agraph  
7,x7 ! foll[+ new subp>agraph3  7,y7    
beg9n+ #ab mon?s aft] ! date ( !        
enactm5t ( ?is subp>agraph1 9 ! case ( a
 hospital or critical access hospital1 )
 respect to ea* individual :o receives  
obs]vation s]vices z an outpati5t at su*
 hospital or critical access hospital = 
m ?an #bd h\rs1 to provide to su*       
individual n lat] ?an #cf h\rs aft] ! "t
 su* individual beg9s receiv+ su*       
s]vices 7or1 if soon]1 ^u release7--    
7i7 su* oral explanation ( ! writt5     
notification describ$ 9 clause 7ii71 &  
su* docum5tation ( ! provision ( su*    
explanation1 z ! ,secret>y det]m9es to  
be appropriate2  7ii7 a writt5          
notification 7z specifi$ by ! ,secret>y 
pursuant to rulemak+ & conta9+ su*      
language z ! ,secret>y prescribes       
consi/5t ) ?is p>agraph7 :i*--  7,i7    
expla9s ! /atus ( ! individual z an     
outpati5t receiv+ obs]vation s]vices & n

 z an inpati5t ( ! hospital or critical 
access hospital & ! reasons = su* /atus 
( su* individual2  7,,ii7 expla9s !     
implications ( su* /atus on s]vices     
furni%$ by ! hospital or critical access
 hospital 7includ+ s]vices furni%$ on an
 inpati5t basis71 su* z implications =  
co/-%>+ requirem5ts "u ?is title & =    
subsequ5t eligibility = cov]age "u ?is  
title = s]vices furni%$ by a skill$     
nurs+ facility2  7,,iii7 includes su*   
additional in=mation z ! ,secret>y      
det]m9es appropriate2  7,,iv7 ei!r--    
7aa7 is sign$ by su* individual or a    
p]son act+ on su* individual's behalf to
 ackn[l$ge receipt ( su* notification2  
or  7bb7 if su* individual or p]son     
refuses to provide ! signature describ$ 
9 item 7aa71 is sign$ by ! /aff memb] ( 
! hospital or critical access hospital  
:o pres5t$ ! writt5 notification &      
includes ! "n & title ( su* /aff memb]1 
a c]tification t ! notification 0       
pres5t$1 & ! date & "t ! notification 0 
pres5t$2 &  7,v7 is writt5 & =matt$ us+ 

pla9 language & is made available 9     
appropriate languages z det]m9$ by !    
,secret>y4  4