,i #aaith ,,congress #ast ,session ,h4 ,r4 #cacd ,,in ,,the ,,house ,,of ,,representatives ,may #a1 #bjbe ,mr4 ,arrington 7for himself1 ,mr4 ,vicente ,gonzalez of ,texas1 ,mr4 ,crenshaw1 and ,ms4 ,van ,duyne7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committee on ,ways and ,means1 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 titles ,,xviii and ,,xix of the ,social ,security ,act to provide for coverage of certain services furnished by freestanding emergency centers4 #a4 ,short title ,this ,act may be cited as the ,emergency ,care ,improvement ,act4 #b4 ,findings ,congress finds the following3 7#a7 ,to expand provider capacity to respond to the ,,covid-#ai pandemic1 in ,april of #bjbj the ,centers for ,medicare ,medicaid ,services issued a waiver allowing freestanding emergency centers 7,f,e,cs7 to enroll as ,medicare-certified hospitals and receive ,medicare reimbursement for the duration of the ,,covid-#ai public health emergency4 7#b7 ,f,e,cs are fully licensed emergency departments that are staffed by both ,emergency ,medicine trained physicians and registered nurses who are on-site #bd hours a day1 seven days a week1 and possess licensed pharmacies1 clinical laboratories1 and advanced imaging services4 ,f,e,cs are ,state-licensed1 and adhere to the same standards and provide the same level of care as ,hospital ,based ,emergency ,rooms1 including ,state ,,emtala regulations on treating all patients4 7#c7 ,over #aah ,f,e,cs1 mostly located in ,texas1 have enrolled and provided high-quality emergency services for all kinds of emergency conditions at significant savings to the ,medicare program and to thousands of ,medicare beneficiaries4 7#d7 ,an actuarial study of ,medicare claims data found that ,f,e,cs did not increase overall utilization of emergency care services and saved the ,medicare program #ba4h percent in lower emergency care payments for patients of similar acuity4 #c4 ,coverage of freestanding emergency centers under ,medicare and ,medicaid 7a7 ,coverage under ,medicare part ,b ,section #ahcb7;a77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciek7a77 is amended-- 7#a7 in subparagraph 7,i71 by striking and at the end2 7#b7 in subparagraph 7,j71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following new subparagraph3 7,k7 specified emergency services furnished by a freestanding emergency center 7as such terms are defined in section #ahfa7nnn774 4 7b7 ,definitions ,section #ahfa of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7 is amended by adding at the end the following new subsection3 7nnn7 ,freestanding emergency center2 specified emergency services 7#a7 ,freestanding emergency center ,the term freestanding emergency center means a health care facility that-- 7,a7 is an independent freestanding emergency department 7as defined in section #bgii;,a-#a7;a77#c77;,d7 of the ,public ,health ,service ,act72 7,b7 is staffed #bd hours a day1 #g days a week1 with a physician 7as defined in subsection 7r77#a77 available to furnish emergency services 7as defined in section #bgii;,a-#a7;a77#c77;,c77i7 of the ,public ,health ,service ,act7 in such facility #bd hours a day2 7,c7 has arrangements with one or more hospitals1 having agreements in effect under section #ahff1 for the referral and admission of patients requiring inpatient services or such diagnostic or other specialized services as are not available at such facility2 7,d7 has established a governing body to determine1 implement1 and monitor policies governing the total operation of the facility2 7,e7 develops1 implements1 and maintains an ongoing1 data-driven quality assessment and performance improvement program1 and has oversight and accountability for such program1 ensuring that facility policies and such program are administered so as to provide quality health care in a safe environment2 7,f7 is located-- 7i7 in a metropolitan statistical area2 or 7ii7 7,i7 in the case of a facility established prior to #bjbb1 in a rural county2 or 7,,ii7 in the case of a facility established on or after ,january #a1 #bjbb1 in a rural county that does not have a ,medicare-certified hospital or a rural emergency hospital 7as defined in subsection 7kkk77#b772 and 7,g7 meets all ,state requirements applicable to facilities that furnish emergency medical services to individuals but do not typically provide for stays in excess of #bd hours1 and meets such other requirements as the ,secretary may prescribe not in excess of the conditions of participation under this title that are applicable to off campus dedicated emergency departments of hospitals 7as described in section #dhb4ee of title #db1 ,code of ,federal ,regulations 7or any successor regulation774 7#b7 ,specified emergency services ,the term specified emergency services means emergency services 7as defined in section #bgii;,a-#a7;a77#c77;,c77i7 of the ,public ,health ,service ,act7 other than a service identified1 as of the date of the enactment of the ,emergency ,care ,improvement ,act1 by any of ,,hcpcs evaluation and service management service codes #iibha through #iibhb4 4 7c7 ,application of ,,emtala ,section #ahfg7;e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;dd7e77 is amended-- 7#a7 in paragraph 7#b71 by-- 7,a7 inserting other than a freestanding emergency center 7as defined in section #ahfa7nnn77 after a hospital2 and 7,b7 inserting or a freestanding emergency center 7as so defined7 participating under this title before the period at the end2 and 7#b7 in paragraph 7#e71 by inserting at the end the following new sentence3 ,beginning on the date of the enactment of the ,emergency ,care ,improvement ,act1 such term also includes a freestanding emergency center 7as defined in section #ahfa7nnn771 and any reference to a hospital that has a hospital emergency department includes such a freestanding emergency center44 7d7 ,payment under ,medicare ,section #ahcc7;a77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7a77#b77 is amended-- 7#a7 in subparagraph 7,g77ii71 by striking and at the end2 7#b7 in subparagraph 7,h71 by striking the comma at the end and inserting 2 and2 and 7#c7 by inserting after subparagraph 7,h7 the following new subparagraph3 7,i7 with respect to specified emergency services furnished by a freestanding emergency center 7as such terms are defined in section #ahfa7nnn771 the amount that would have been determined under subsection 7t7 if such services had been covered ,,opd services1 4 7e7 ,coverage under ,medicaid ,section #aije7;a77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77#b77 is amended-- 7#a7 in subparagraph 7,b71 by striking and at the end2 and 7#b7 by inserting before the semicolon at the end the following3 1 and 7,d7 specified emergency services furnished by freestanding emergency centers 7as such terms are defined in section #ahfa7nnn774 7f7 ,exclusion from prohibition on physician self-,referral ,section #ahgg7;b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acienn7b77 is amended by adding at the end the following new paragraph3 7#f7 ,freestanding emergency centers ,in the case of laboratory services and imaging services furnished by a freestanding emergency center in connection with specified emergency services 7as such terms are defined in section #ahfa7nnn774 4 7g7 ,effective date ,the amendments made by this ,act shall apply with respect to items and services furnished on or after the date of the enactment of this ,act4