,i #aai? ,,congress #a/ ,session ,h4 ,r4 #cacd ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,may #a1 #bjbe ,mr4 ,arr+ton 7= himself1 ,mr4 ,vic5te ,gonzalez ( ,texas1 ,mr4 ,cr5%aw1 & ,ms4 ,van ,duyne7 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 ( c]ta9 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] #aah ,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$-- 7#a7 9 subp>agraph 7,i71 by /rik+ & at ! end2 7#b7 9 subp>agraph 7,j71 by /rik+ ! p]iod at ! end & ins]t+ 2 &2 & 7#c7 by add+ at ! end ! foll[+ new subp>agraph3 7,k7 specifi$ em]g5cy s]vices furni%$ by a free/&+ em]g5cy c5t] 7z su* t]ms are def9$ 9 section #ahfa7nnn774 4 7b7 ,def9itions ,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]2 specifi$ em]g5cy s]vices 7#a7 ,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 /aff$ #bd h\rs a day1 #g days a week1 ) a physician 7z def9$ 9 subsection 7r77#a77 available to furni% em]g5cy s]vices 7z def9$ 9 section #bgii;,a-#a7;a77#c77;,c77i7 ( ! ,public ,heal? ,s]vice ,act7 9 su* facility #bd h\rs a day2 7,c7 has arrangem5ts ) "o or m hospitals1 hav+ agreem5ts 9 effect "u section #ahff1 = ! ref]ral & admission ( pati5ts requir+ inpati5t s]vices or su* diagno/ic or o!r specializ$ s]vices z are n available at su* facility2 7,d7 has e/abli%$ a gov]n+ body to det]m9e1 implem5t1 & monitor policies gov]n+ ! total op]ation ( ! facility2 7,e7 develops1 implem5ts1 & ma9ta9s an ongo+1 data-driv5 quality assessm5t & p]=mance improvem5t program1 & has ov]sight & acc\ntability = su* program1 ensur+ t facility policies & su* program are adm9i/]$ s z to provide quality heal? c>e 9 a safe environm5t2 7,f7 is locat$-- 7i7 9 a metropolitan /ati/ical area2 or 7ii7 7,i7 9 ! case ( a facility e/abli%$ prior to #bjbb1 9 a rural c\nty2 or 7,,ii7 9 ! case ( a facility e/abli%$ on or aft] ,janu>y #a1 #bjbb1 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,g7 meets all ,/ate requirem5ts applicable to facilities t furni% em]g5cy m$ical s]vices to individuals b d n typically provide = /ays 9 excess ( #bd h\rs1 & meets su* o!r requirem5ts z ! ,secret>y may prescribe n 9 excess ( ! conditions ( p>ticipation "u ?is title t are applicable to (f campus d$icat$ em]g5cy dep>tm5ts ( hospitals 7z describ$ 9 section #dhb4ee ( title #db1 ,code ( ,f$]al ,regulations 7or any successor regulation774 7#b7 ,specifi$ em]g5cy s]vices ,! t]m specifi$ em]g5cy s]vices means em]g5cy s]vices 7z def9$ 9 section #bgii;,a-#a7;a77#c77;,c77i7 ( ! ,public ,heal? ,s]vice ,act7 o!r ?an a s]vice id5tifi$1 z ( ! date ( ! enactm5t ( ! ,em]g5cy ,c>e ,improvem5t ,act1 by any ( ,,hcpcs evaluation & s]vice managem5t s]vice codes #iibha ?r\gh #iibhb4 4 7c7 ,application ( ,,emtala ,section #ahfg7;e7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;dd7e77 is am5d$-- 7#a7 9 p>agraph 7#b71 by-- 7,a7 ins]t+ o!r ?an a free/&+ em]g5cy c5t] 7z def9$ 9 section #ahfa7nnn77 aft] a hospital2 & 7,b7 ins]t+ or a free/&+ em]g5cy c5t] 7z s def9$7 p>ticipat+ "u ?is title be=e ! p]iod at ! end2 & 7#b7 9 p>agraph 7#e71 by ins]t+ at ! end ! foll[+ new s5t5ce3 ,beg9n+ on ! date ( ! enactm5t ( ! ,em]g5cy ,c>e ,improvem5t ,act1 su* t]m also includes a free/&+ em]g5cy c5t] 7z def9$ 9 section #ahfa7nnn771 & any ref]5ce to a hospital t has a hospital em]g5cy dep>tm5t includes su* a free/&+ em]g5cy c5t]44 7d7 ,paym5t "u ,m$ic>e ,section #ahcc7;a77#b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciel7a77#b77 is am5d$-- 7#a7 9 subp>agraph 7,g77ii71 by /rik+ & at ! end2 7#b7 9 subp>agraph 7,h71 by /rik+ ! comma at ! end & ins]t+ 2 &2 & 7#c7 by ins]t+ aft] subp>agraph 7,h7 ! foll[+ new subp>agraph3 7,i7 ) respect to specifi$ em]g5cy s]vices furni%$ by a free/&+ em]g5cy c5t] 7z su* t]ms are def9$ 9 section #ahfa7nnn771 ! am\nt t w\ld h be5 det]m9$ "u subsection 7t7 if su* s]vices _h be5 cov]$ ,,opd s]vices1 4 7e7 ,cov]age "u ,m$icaid ,section #aije7;a77#b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77#b77 is am5d$-- 7#a7 9 subp>agraph 7,b71 by /rik+ & at ! end2 & 7#b7 by ins]t+ be=e ! semicolon at ! end ! foll[+3 1 & 7,d7 specifi$ em]g5cy s]vices furni%$ by free/&+ em]g5cy c5t]s 7z su* t]ms are def9$ 9 section #ahfa7nnn774 7f7 ,exclusion f prohibition on physician self-,ref]ral ,section #ahgg7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acienn7b77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#f7 ,free/&+ em]g5cy c5t]s ,9 ! case ( laboratory s]vices & imag+ s]vices furni%$ by a free/&+ em]g5cy c5t] 9 connection ) specifi$ em]g5cy s]vices 7z su* t]ms are def9$ 9 section #ahfa7nnn774 4 7g7 ,effective date ,! am5dm5ts made by ?is ,act %all apply ) respect to items & s]vices furni%$ on or aft] ! date ( ! enactm5t ( ?is ,act4