,i  #aah? ,,congress  #a/ ,session  ,h4 
,r4 #afid  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,m>* #bb1 #bjbc,mr4   
,arr+ton 7= himself1 ,mr4 ,vic5te       
,gonzalez ( ,texas1 ,mr4 ,cl\d1 ,mr4    
,burgess1 & ,mr4 ,sessions7 introduc$ ! 
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,en]gy & ,comm]ce1 & 9    
addition to ! ,committee on ,ways &     
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d titles ,,xviii & ,,xix
 ( ! ,social ,security ,act to provide =
 cov]age ( 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 ,f9d+s ,congress 
f9ds ! foll[+3 7#a7 ,to exp& provid]    
capacity to respond to ! ,,covid-#ai    
p&emic1 9 ,april ( #bjbj ! ,c5t]s =     
,m$ic>e  ,m$icaid ,s]vices issu$ a waiv]
 all[+ free/&+ em]g5cy c5t]s 7,f,e,cs7  
to enroll z ,m$ic>e-c]tifi$ hospitals & 

receive ,m$ic>e reimbursem5t = !        
duration ( ! ,,covid-#ai public heal?   
em]g5cy4  7#b7 ,f,e,cs are fully lic5s$ 
em]g5cy dep>tm5ts t are /aff$ by bo?    
,em]g5cy ,m$ic9e tra9$ physicians &     
regi/]$ nurses :o are on-site #bd h\rs a
 day1 sev5 days a week1 & possess lic5s$
 ph>macies1 cl9ical laboratories1 &     
advanc$ imag+ s]vices4 ,f,e,cs are      
,/ate-lic5s$1 & adh]e to ! same /&>ds & 
provide ! same level ( c>e z ,hospital  
,bas$ ,em]g5cy ,rooms1 includ+ ,/ate    
,,emtala regulations on treat+ all      
pati5ts4  7#c7 ,ov] #aaj ,f,e,cs1 mo/ly 
locat$ 9 ,texas1 h enroll$ & provid$    
high-quality em]g5cy s]vices = all k9ds 
( em]g5cy conditions at significant     
sav+s to ! ,m$ic>e program & to ?\s&s ( 
,m$ic>e b5efici>ies4  7#d7 ,an actu>ial 
/udy ( ,m$ic>e claims data f\nd t       
,f,e,cs did n increase ov]all           
utilization ( em]g5cy c>e s]vices & sav$
 ! ,m$ic>e program #ba4h p]c5t 9 l[]    
em]g5cy c>e paym5ts = pati5ts ( simil>  
acuity4  #c4 ,cov]age ( free/&+ em]g5cy 

c5t]s "u m$ic>e & m$icaid  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 em]g5cy s]vices 7z def9$ 9 section 
#bgii;,a-#a7;a77#c77;,c7 ( ! ,public    
,heal? ,s]vice ,act7 provid$ by a       
free/&+ em]g5cy c5t] 7z def9$ 9 section 
#ahfa7nnn774  4  7b7 ,free/&+ em]g5cy   
c5t] def9$ ,section #ahfa ( ! ,social   
,security ,act 7#db ,u4,s4,c4 #aciex7 is
 am5d$ by add+ at ! end ! foll[+ new    
subsection3  7nnn7 ,free/&+ em]g5cy c5t]
 ,! t]m free/&+ em]g5cy c5t] means a    
heal? c>e facility t-- 7#a7 is an       
indep5d5t free/&+ em]g5cy dep>tm5t 7z   
def9$ 9 section #bgii;,a-#a7;a77#c77;,d7
 ( ! ,public ,heal? ,s]vice ,act72  7#b7
 is op]ational #bd h\rs a day1 #g days a
 week1 & #cfe days a ye> ) a physician  
7z def9$ 9 subsection 7r77 onsite &     

available 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 is   
locat$-- 7,a7 9 a metropolitan /ati/ical
 area2 or  7,b7 7i7 9 ! case ( a        
facility e/abli%$ prior to #bjbj1 9 a   
rural c\nty2 or  7ii7 9 ! case ( a      
facility e/abli%$ on or aft] ,janu>y #a1
 #bjbj1 9 a rural c\nty t does n h a    
,m$ic>e-c]tifi$ hospital or a rural     
em]g5cy hospital 7z def9$ 9 subsection  
7kkk77#b772  7#f7 has e/abli%$ a gov]n+ 
body to det]m9e1 implem5t1 & monitor    
policies gov]n+ ! total op]ation ( !    
facility1 & has ov]sight & acc\ntability
 = ! ,,qapi program1 ensur+ t facility  
policies & su* ,,qapi program are       
adm9i/]$ s z to provide quality heal?   
c>e 9 a safe environm5t2 &  7#g7 meets  
all ,/ate requirem5ts applicable to     
facilities :i* furni% em]g5cy m$ical    
s]vices to individuals b d n typically  

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 7z
 describ$ 9 section #dhb4ee ( title #db1
 ,code ( ,f$]al ,regulations 7or any    
successor regulation771 & n ! conditions
 ( p>ticipation "u ?is title t are      
applicable to hospitals 7z def9$ 9      
subsection 7e771 includ+ rural em]g5cy  
hospitals 7z def9$ 9 subsection         
7kkk77#b771 o!r ?an ) respect to        
compliance ) ! requirem5ts describ$ 9   
section #ahfg2  4  7c7 ,paym5t "u       
,m$ic>e ,section #ahcc7t77#ba7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciel7t77#ba77 is am5d$ by add+ at !   
end ! foll[+ new subp>agraph3  7,f7     
,treatm5t ( free/&+ em]g5cy c5t]s ,!    
facility paym5t rate = s]vices ( a      
free/&+ em]g5cy c5t] 7z def9$ 9 section 
#ahfa7nnn77 = high] acuity evaluation or
 managem5t level s]vices 7z repres5t$ by

 ,,hcpcs codes #iibhc-iibhe1 or any     
successor codes7 %all be 9 an am\nt     
equal to ! paym5t t w\ld o!rwise apply  
to a hospital outpati5t dep>tm5t "u ?is 
subsection1 includ+ ! application ( !   
geographic adju/m5t "u p>agraph         
7#b77;,d7 & ! ,,opd fee s*$ule increase 
factor "u p>agraph 7#c77;,c77iv74  4    
7d7 ,cov]age "u ,m$icaid ,section       
#aije7;a77#b77;,a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acif;d7a77#b77;,a77 is am5d$ by ins]t+ 
1 includ+ ! s]vices ( free/&+ em]g5cy   
c5t]s 7z def9$ 9 section #ahfa7nnn77    
aft] outpati5t hospital s]vices4  7e7   
,effective date ,! am5dm5ts made by ?is 
,act %all apply ) respect to items &    
s]vices furni%$ on or aft] ,may #aa1    
#bjbc4