,i  #aafth ,,congress  #b;d ,session    
,h4 ,r4 #gead  ,,in ,,the ,,house ,,of  
,,representatives  ,july #i1 #bjbj,mr4  
,rodney ,davis of ,illinois 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 require1  
as a condition of participation under   
the ,medicare program1 each hospital to 
adopt and implement evidence-based      
sepsis protocols1 and for other         
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,gabby's ,law ,act 4
  #b4 ,requirement as condition of      
participation under ,medicare program   
for hospitals to adopt and implement    
evidence-based sepsis protocols  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,w71 by moving the margin 
of such subparagraph #b ems to the left2
  7#b7 in subparagraph 7,x7-- 7,a7 by   
moving the margin of such subparagraph  
#b ems to the left2 and  7,b7 by        
striking and at the end2  7#c7 in       
subparagraph 7,y77ii77,v71 by striking  
the period at the end and inserting 1   
and2 and  7#d7 by inserting after       
subparagraph 7,y7 the following new     
subparagraph3  7,z7 beginning on the    
date that is one year after the date of 
the enactment of this subparagraph1 in  
the case of a hospital-- 7i7 to adopt1  
implement1 and periodically update      
evidence-based sepsis protocols 7as     
defined in section #ahfa7kkk772 and     
7ii7 to ensure that professional staff  
of the hospital with direct patient care
 responsibilities and1 as determined    
appropriate by the hospital1 staff of   
the hospital with indirect patient care 
responsibilities 7including laboratory  

and pharmacy staff7 periodically receive
 training 7which shall be updated in    
accordance with any substantial update  
made under clause 7i7 to the            
evidence-based sepsis protocols of the  
hospital7 to implement such             
evidence-based sepsis protocols4  4  7b7
 ,evidence-,based sepsis protocols      
defined ,section #ahfa of the ,social   
,security ,act 7#db ,u4,s4,c4 #aciex7 is
 amended by adding at the end the       
following new subsection3  7kkk7        
,evidence-,based sepsis protocols ,the  
term evidence-based sepsis protocols    
means1 with respect to a hospital1      
protocols based on generally accepted   
standards of care for the early         
recognition and treatment of individuals
 with sepsis1 severe sepsis1 or septic  
shock and that include each of the      
following3 7#a7 ,a process for          
identifying 7including through          
screenings7 and providing treatment for 
adults with sepsis1 severe sepsis1 or   
septic shock1 taking into account       

whether such treatment is being provided
 as an inpatient hospital service or in 
the emergency department of the         
hospital4  7#b7 ,a process for          
identifying 7including through          
screenings7 and providing treatment for 
children with sepsis1 severe sepsis1 or 
septic shock1 taking into account       
whether such treatment is being provided
 as an inpatient hospital service or in 
the emergency department of the         
hospital4  7#c7 ,a process and explicit 
criteria for excluding certain          
individuals1 such as an individual with 
an exclusionary clinical condition 7as  
specified by the hospital7 or an        
individual who has elected palliative   
care1 from the process described in     
paragraph 7#a7 or 7#b74  7#d7           
,guidelines for hemodynamic support with
 explicit physiologic and treatment     
goals1 a methodology for invasive and   
non-invasive hemodynamic monitoring1 and
 timeframe goals4  7#e7 ,with respect to
 children 7including infants71          

guidelines for fluid resuscitation      
consistent with any evidence-based      
guidelines for severe sepsis and septic 
shock that have defined therapeutic     
goals for children4  7#f7 ,a process for
 identifying the infectious source of   
the sepsis1 severe sepsis1 or septic    
shock and delivering early broad        
spectrum antibiotics with timely        
reevaluation to adjust treatment in a   
manner that targets any identified      
infectious source4  7#g7 ,criteria for  
use1 based on accepted evidence of      
vasoactive agents4  4