,i  #aafth ,,congress  #b;d ,session    
,h4 ,r4 #egbg  ,,in ,,the ,,house ,,of  
,,representatives  ,january #cj1        
#bjbj,mr4 ,rush 7for himself1 ,mr4      
,thompson of ,mississippi1 ,mrs4 ,watson
 ,coleman1 and ,ms4 ,barragn7 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 provide for a study by   
the ,national ,academy of ,medicine on  
ambulance diversions1 and for other     
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,research ,empirical
 ,solutions to ,end ,ambulance          
,reversals from ,closed ,hospitals ,act 
of #bjbj or the ,,research ,act of      
#bjbj4  #b4 ,study on ambulance         
diversions  7a7 ,study ,the ,secretary  
of ,health and ,human ,services shall   

seek to enter into an agreement with the
 ,national ,academy of ,medicine under  
which the ,national ,academy agrees to  
conduct a study on ambulance diversions1
 including--  7#a7 whether the number of
 such diversions have increased over the
 last #aj years1 including whether the  
number of such diversions have increased
 at the national1 regional1 ,state1 and 
local level2  7#b7 what steps1 if any1  
have been taken to reduce the number of 
such diversions2  7#c7 whether such     
diversions disproportionately impact    
medically underserved communities 7as   
defined in section #gii;,b of the       
,public ,health ,service ,act 7#db      
,u4,s4,c4 #biep772 and  7#d7 what       
actions the ,federal ,government should 
take-- 7,a7 to reduce the number of     
ambulance diversions2 and  7,b7 to      
improve the health and safety of        
patients affected by ambulance          
diversions4  7b7 ,consultation ,the     
agreement under subsection 7a7 shall    
require the study under such agreement  

to be conducted in consultation with--  
7#a7 the ,assistant ,secretary for      
,planning and ,evaluation of the        
,department of ,health and ,human       
,services2  7#b7 the ,assistant         
,secretary for ,preparedness and        
,response of the ,department of ,health 
and ,human ,services2 and  7#c7 the     
,director of the ,office of ,emergency  
,care ,research of the ,national        
,institutes of ,health4  7c7 ,report    
,the agreement under subsection 7a7     
shall provide for--  7#a7 the submission
 to the congressional committees of     
jurisdiction1 not later than #bd months 
after the date of enactment of this     
,act1 of a report on the results of the 
study under such agreement2 and  7#b7   
the inclusion in such report of         
recommendations on actions the ,federal 
,government should take-- 7,a7 to       
mitigate the occurrence of ambulance    
diversions2 and  7,b7 to improve the    
health and safety of patients affected  
by ambulance diversions4  7d7           

,definition ,in this section1 the term  
ambulance diversion means the temporary 
closure of a hospital emergency         
department to incoming ambulances4  #c4 
,hospital reporting requirement  7a7    
,reporting requirement ,a hospital shall
 report to the ,secretary of ,health and
 ,human ,services1 in the case the      
hospital implements an ambulance        
diversion on or after ,january #a1      
#bjba--  7#a7 how long the diversion was
 in effect2  7#b7 the reason for the    
diversion2 and  7#c7 the number of      
ambulance calls the hospital diverted   
while the diversion was in effect4  7b7 
,enforcement  7#a7 ,hospitals ,section  
#ahhf7;d77#e7 of the ,social ,security  
,act 7#db ,u4,s4,c4 #acieww7d77#e77 is  
amended by adding at the end the        
following new subparagraph3  7,m7  7i7  
7,i7 ,in the case that the ,secretary   
determines1 with respect to a calendar  
quarter occurring in the period         
beginning with #bjba and ending with    
#bjbd1 that a hospital has complied with

 the provisions of section #c7;a7 of the
 ,,research ,act of #bjbj with respect  
to each ambulance diversion 7if any7    
that occurred during such quarter1 the  
,secretary shall increase1 by the       
percentage specified in subclause 7,,ii7
 for such quarter1 the amount otherwise 
payable to such hospital under paragraph
 7#a77;,a7 for discharges occurring in  
the succeeding quarter4  7,,ii7 ,for    
purposes of subclause 7,i71 the         
percentage specified in this subclause  
is1 with respect to a calendar quarter  
occurring in--  7aa7 #bjba or #bjbb1 #a 
percent2 or  7bb7 #bjbc or #bjbd1 #j4e  
percent4  7ii7  7,i7 ,in the case that  
the ,secretary determines1 with respect 
to a calendar quarter occurring in #bjbe
 or a subsequent year1 that a hospital  
has failed to report an ambulance       
diversion occurring during such quarter 
to the ,secretary in accordance with    
section #c7;a7 of the ,,research ,act of
 #bjbj1 the ,secretary shall reduce1 by 
the percentage specified in subclause   

7,,ii7 for such quarter1 the amount     
otherwise payable to such hospital under
 paragraph 7#a77;,a7 for discharges     
occurring in the succeeding quarter4    
7,,ii7 ,for purposes of subclause 7,i71 
the percentage specified in this        
subclause is1 with respect to a calendar
 quarter occurring in--  7aa7 #bjbe1 #a 
percent2 or  7bb7 #bjbf or a subsequent 
year1 #b percent4  7iii7 ,in this       
subparagraph1 the term ambulance        
diversion has the meaning given such    
term in section #b of the ,,research    
,act of #bjbj4  4  7#b7 ,critical access
 hospitals ,section #ahad7l7 of the     
,social ,security ,act 7#db ,u4,s4,c4   
#acie;f7l77 is amended by adding at the 
end the following new paragraph3  7#f7  
7,a7  7i7 ,in the case that the         
,secretary determines1 with respect to a
 calendar quarter occurring in the      
period beginning with #bjba and ending  
with #bjbd1 that a critical access      
hospital has complied with the          
provisions of section #c7;a7 of the     

,,research ,act of #bjbj with respect to
 each ambulance diversion 7if any7 that 
occurred during such quarter1 the       
,secretary shall increase1 by the       
percentage specified in clause 7ii7 for 
such quarter1 the amount otherwise      
payable to such hospital under paragraph
 7#a7 for services furnished during the 
succeeding quarter4  7ii7 ,for purposes 
of clause 7i71 the percentage specified 
in this clause is1 with respect to a    
calendar quarter occurring in--  7,i7   
#bjba or #bjbb1 #a percent2 or  7,,ii7  
#bjbc or #bjbd1 #j4e percent4  7,b7  7i7
 ,in the case that the ,secretary       
determines1 with respect to a calendar  
quarter occurring in #bjbe or a         
subsequent year1 that a critical access 
hospital has failed to report an        
ambulance diversion occurring during    
such quarter to the ,secretary in       
accordance with section #c7;a7 of the   
,,research ,act of #bjbj1 the ,secretary
 shall reduce1 by the percentage        
specified in clause 7ii7 for such       

quarter1 the amount otherwise payable to
 such hospital under paragraph 7#a7 for 
services furnished during the succeeding
 quarter4  7ii7 ,for purposes of clause 
7i71 the percentage specified in this   
clause is1 with respect to a calendar   
quarter occurring in--  7,i7 #bjbe1 #a  
percent2 or  7,,ii7 #bjbf or a          
subsequent year1 #b percent4  4  7c7    
,definition ,in this section3 7#a7 ,the 
term ambulance diversion has the meaning
 given to such term in section #b4  7#b7
 ,the term hospital means a subsection  
7d7 hospital 7as defined in section     
#ahhf7;d77#a77;,b7 of the ,social       
,security ,act 7#db ,u4,s4,c4           
#acieww7d77#a77;,b7771 or a critical    
access hospital 7as defined in section  
#ahfa7mm7 of such ,act 7#db ,u4,s4,c4   
#aciex7mm7771 enrolled under section    
#ahff7;j7 of such ,act 7#db ,u4,s4,c4   
#acib;cc7j774