,,ii  #aae? ,,congress  #b;d ,session   
,s4 #ceca  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #bh1 #bjah   
,mr4 ,cassidy introduc$ ! foll[+ bill2  
:i* 0 read twice & ref]r$ to !          
,committee on ,f9ance  ,a ,,bill  ,to   
am5d titles ,,xviii & ,,xix ( ! ,social 
,security ,act to provide cov]age "u    
,m$ic>e & ,m$icaid ( s]vices furni%$ by 
free/&+ em]g5cy c5t]s4  #a4 ,%ort title 
,?is ,act may be cit$ z ! ,em]g5cy ,c>e 
,improvem5t ,act4  #b4 ,cov]age "u      
,m$ic>e & ,m$icaid ( s]vices furni%$ by 
free/&+ em]g5cy c5t]s  7a7 ,cov]age "u  
,m$ic>e "p ,b ,section #ahcb7;a77#b7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#aciek7a77 is am5d$-- 7#a7 9 subp>agraph
 7,i71 by /rik+ & at ! end2  7#b7 9     
subp>agraph 7,j71 by /rik+ ! p]iod at ! 
end & ins]t+ 2 &2 &  7#c7 by add+ at !  
end ! foll[+ new subp>agraph3  7,k7     
s]vices ( a free/&+ em]g5cy c5t]1 z     
def9$ 9 section #ahfa7;jjj74  4  7b7    
,def9ition ( free/&+ em]g5cy c5t]       
,section #ahfa ( ! ,social ,security    

,act 7#db ,u4,s4,c4 #aciex7 is am5d$ by 
add+ at ! end ! foll[+ new subsection3  
7jjj7 ,free/&+ em]g5cy c5t] ,! t]m      
free/&+ em]g5cy c5t] means a facility n 
own$ by a hospital :i*-- 7#a7 meets all 
,/ate requirem5ts applicable to         
facilities :i* furni% em]g5cy m$ical    
s]vices to individuals b does n g5]ally 
provide = /ays 9 excess ( #bd h\rs1 &   
meets su* o!r requirem5ts z ! ,secret>y 
may prescribe n 9 excess ( ! conditions 
( p>ticipation "u ?is title t are       
specifically applicable to (f campus    
d$icat$ em]g5cy dep>tm5ts ( hospitals z 
describ$ 9 section #dhb4ee ( title #db1 
,code ( ,f$]al ,regulations 7or any     
successor regulations71 & n ! conditions
 ( p>ticipation "u ?is title t are      
applicable to hospitals g5]ally o!r ?an 
) respect to compliance ) section #ahfg 
7commonly kn[n z ,,emtala72  7#b7 is    
op]ational #bd h\rs a day1 #g days a    
week1 & #cfe days a ye> ) onsite access 
to physicians at all times2  7#c7 has 9 
place me*anisms to all[ = appropriate   

transf]s & ref]rals2  7#d7 develops1    
implem5ts1 & ma9ta9s an ongo+1          
data-driv5 quality assessm5t & p]=mance 
improvem5t 7,,qapi7 program2  7#e7      
e/abli%es a gov]n+ body t assumes full  
legal responsibility = det]m9+1         
implem5t+1 & monitor+ policies gov]n+ ! 
total op]ation ( ! facility & has       
ov]sight & acc\ntability = ! quality    
assessm5t & p]=mance improvem5t program1
 ensur+ t facility policies & ! program 
are adm9i/]$ s z to provide quality     
heal? c>e 9 a safe environm5t2 &  7#f7  
has a writt5 agreem5t ) ! ,secret>y to  
provide em]g5cy m$ical s]vices to       
b5efici>ies4  4  7c7 ,m$ic>e paym5t &   
c]ta9 report+ ,section #ahcc7t77#ba7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#aciel7t77#ba77 is am5d$ by add+ at !   
end ! foll[+ new subp>agraphs3  7,f7    
,treatm5t ( free/&+ em]g5cy c5t]s ,!    
facility paym5t rate = s]vices ( a      
free/&+ em]g5cy c5t] 7z def9$ 9 section 
#ahfa7;jjj77 = high] acuity evaluation  
or managem5t level s]vices 7repres5t$ by

 ,,hcpcs codes #iibhc-iibhe7 %all be an 
am\nt equal to--  7i7 9 ! case ( s]vices
 furni%$ by su* a c5t] 9 an urban area1 
#ge p]c5t ( ! am\nt ( paym5t t w\ld     
o!rwise apply "u ?is subsection1 includ+
 application ( ! geographic adju/m5t "u 
p>agraph 7#b77;,d7 & ! ,,opd fee s*$ule 
increase factor "u p>agraph             
7#c77;,c77iv72 &  7ii7 9 ! case (       
s]vices furni%$ by su* a c5t] locat$ 9 a
 rural area1 #ie p]c5t ( ! am\nt (      
paym5t t w\ld o!rwise apply "u ?is      
subsection1 includ+ application ( !     
geographic adju/m5t "u p>agraph         
7#b77;,d7 & ! ,,opd fee s*$ule increase 
factor "u p>agraph 7#c77;,c77iv74  7,g7 
,use ( claims modifi] ,a hospital-own$  
(f-campus em]g5cy dep>tm5t %all be      
requir$ to add a claims modifi] to      
claims = paym5t "u ?is "p 9 ord] to     
enable track+ ( items & s]vices furni%$ 
by ^? dep>tm5ts "u ?is "p4  4  7d7      
,m$icaid cov]age ,section               
#aije7;a77#b77;,a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    

#acif;d7a77#b77;,a77 is am5d$ by ins]t+ 
! foll[+ aft] outpati5t hospital        
s]vices3 1 :i* %all include ! s]vices ( 
free/&+ em]g5cy c5t]s1 z def9$ 9 section
 #ahfa7;jjj71 & provid$ t hospital-own$ 
(f-campus em]g5cy dep>tm5ts %all be     
requir$ to add a claims modifi] to      
enable track+ ( (f campus em]g5cy       
s]vices furni%$ by ^! dep>tm5ts4  7e7   
,rule ( con/ruction ,no?+ 9 ! provisions
 (1 or am5dm5ts made by1 ?is ,act %all  
be con/ru$ z r$uc+ or o!rwise affect+ ! 
am\nt ( paym5t = any physicians'        
pr(essional s]vices "u ! physician fee  
s*$ule "u section #ahdh ( ! ,social     
,security ,act 7#db ,u4,s4,c4           
#aciew-#d74  7f7 ,effective date ,!     
am5dm5ts made by ?is ,act %all apply to 
items & s]vices furni%$ on or aft]      
,janu>y #a1 #bjai4