119-hr3134

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3134 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 3134

To amend titles XVIII and XIX of the Social Security Act to provide for 
 coverage of certain services furnished by freestanding emergency 
 centers.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 May 1, 2025

 Mr. Arrington (for himself, Mr. Vicente Gonzalez of Texas, Mr. 
 Crenshaw, and Ms. Van Duyne) introduced the following bill; which was 
 referred to the Committee on Energy and Commerce, and in addition to 
 the Committee on Ways and Means, for a period to be subsequently 
 determined by the Speaker, 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 
 centers.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Emergency Care Improvement Act''.

SEC. 2. FINDINGS.

 Congress finds the following:

    (1) To expand provider capacity to respond to the COVID-19 
 pandemic, in April of 2020 the Centers for Medicare & Medicaid 
 Services issued a waiver allowing freestanding emergency 
 centers

    (FECs) to enroll as Medicare-certified hospitals and 
 receive Medicare reimbursement for the duration of the COVID-19 
 public health emergency.

    (2) FECs are fully licensed emergency departments that are 
 staffed by both Emergency Medicine trained physicians and 
 registered nurses who are on-site 24 hours a day, seven days a 
 week, and possess licensed pharmacies, clinical laboratories, 
 and advanced imaging services. FECs are State-licensed, and 
 adhere to the same standards and provide the same level of care 
 as Hospital Based Emergency Rooms, including State EMTALA 
 regulations on treating all patients.

    (3) Over 118 FECs, mostly located in Texas, 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 beneficiaries.

    (4) An actuarial study of Medicare claims data found that 
 FECs did not increase overall utilization of emergency care 
 services and saved the Medicare program 21.8 percent in lower 
 emergency care payments for patients of similar acuity.

SEC. 3. COVERAGE OF FREESTANDING EMERGENCY CENTERS UNDER MEDICARE AND 
 MEDICAID.

    (a) Coverage Under Medicare Part B.--

Section 1832

    (a)

    (2) of the 
Social Security Act (42 U.S.C. 1395k

    (a) ) is amended--

    (1) in subparagraph
            (I) , by striking ``and'' at the end;

    (2) in subparagraph
        (J) , by striking the period at the end 
 and inserting ``; and''; and

    (3) by adding at the end the following new subparagraph:
 ``
        (K) specified emergency services furnished by a 
 freestanding emergency center (as such terms are 
 defined in 

section 1861

    (nnn) ).''.

    (b) 

=== Definitions. ===
-

Section 1861 of the Social Security Act (42 
U.S.C. 1395x) is amended by adding at the end the following new 
subsection:
 ``

    (nnn) Freestanding Emergency Center; Specified Emergency 
Services.--
 ``

    (1) Freestanding emergency center.--The term 
 `freestanding emergency center' means a health care facility 
 that--
 ``
        (A) is an independent freestanding emergency 
 department (as defined in 

section 2799A-1

    (a)

    (3)
            (D) of 
 the Public Health Service Act);
 ``
        (B) is staffed 24 hours a day, 7 days a week, 
 with a physician (as defined in subsection

    (r)

    (1) ) 
 available to furnish emergency services (as defined in 
 

section 2799A-1

    (a)

    (3)
            (C) 
            (i) of the Public Health 
 Service Act) in such facility 24 hours a day;
 ``
            (C) has arrangements with one or more hospitals, 
 having agreements in effect under 

section 1866, for the 
 referral and admission of patients requiring inpatient 
 services or such diagnostic or other specialized 
 services as are not available at such facility;
 ``
            (D) has established a governing body to 
 determine, implement, and monitor policies governing 
 the total operation of the facility;
 ``
        (E) develops, implements, and maintains an 
 ongoing, data-driven quality assessment and performance 
 improvement program, and has oversight and 
 accountability for such program, ensuring that facility 
 policies and such program are administered so as to 
 provide quality health care in a safe environment;
 ``
        (F) is located--
 ``
            (i) in a metropolitan statistical area; 
 or
 ``
            (ii) 
            (I) in the case of a facility 
 established prior to 2022, in a rural county; 
 or
 ``
            (II) in the case of a facility 
 established on or after January 1, 2022, in a 
 rural county that does not have a Medicare-
 certified hospital or a rural emergency 
 hospital (as defined in subsection

    (kkk)

    (2) ); 
 and
 ``
        (G) meets all State requirements applicable to 
 facilities that furnish emergency medical services to 
 individuals but do not typically provide for stays in 
 excess of 24 hours, 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 (as described in 

section 482.55 of title 42, Code of Federal Regulations (or any 
 successor regulation)).
 ``

    (2) Specified emergency services.--The term `specified 
 emergency services' means emergency services (as defined in 
 

section 2799A-1

    (a)

    (3)
            (C) 
            (i) of the Public Health Service Act) 
 other than a service identified, as of the date of the 
 enactment of the Emergency Care Improvement Act, by any of 
 HCPCS evaluation and service management service codes 99281 
 through 99282.''.
            (c) Application of EMTALA.--

Section 1867

    (e) of the Social Security 
Act (42 U.S.C. 1395dd

    (e) ) is amended--

    (1) in paragraph

    (2) , by--
        (A) inserting ``other than a freestanding emergency 
 center (as defined in 

section 1861

    (nnn) )'' after ``a 
 hospital''; and
        (B) inserting ``or a freestanding emergency center 
 (as so defined) participating under this title'' before 
 the period at the end; and

    (2) in paragraph

    (5) , by inserting at the end the following 
 new sentence: ``Beginning on the date of the enactment of the 
 Emergency Care Improvement Act, such term also includes a 
 freestanding emergency center (as defined in 

section 1861

    (nnn) ), and any reference to a hospital that has a hospital 
 emergency department includes such a freestanding emergency 
 center.''.
            (d) Payment Under Medicare.--

Section 1833

    (a)

    (2) of the Social 
Security Act (42 U.S.C. 1395l

    (a)

    (2) ) is amended--

    (1) in subparagraph
        (G)
            (ii) , by striking ``and'' at the 
 end;

    (2) in subparagraph
        (H) , by striking the comma at the end 
 and inserting ``; and''; and

    (3) by inserting after subparagraph
        (H) the following new 
 subparagraph:
 ``
            (I) with respect to specified emergency services 
 furnished by a freestanding emergency center (as such 
 terms are defined in 

section 1861

    (nnn) ), the amount 
 that would have been determined under subsection

    (t) if 
 such services had been covered OPD services,''.

    (e) Coverage Under Medicaid.--

Section 1905

    (a)

    (2) of the Social 
Security Act (42 U.S.C. 1396d

    (a)

    (2) ) is amended--

    (1) in subparagraph
        (B) , by striking ``and'' at the end; 
 and

    (2) by inserting before the semicolon at the end the 
 following: ``, and
            (D) specified emergency services furnished 
 by freestanding emergency centers (as such terms are defined in 
 

section 1861

    (nnn) )''.

    (f) Exclusion From Prohibition on Physician Self-Referral.--

Section 1877

    (b) of the Social Security Act (42 U.S.C. 1395nn

    (b) ) is amended by 
adding at the end the following new paragraph:
 ``

    (6) Freestanding emergency centers.--In the case of 
 laboratory services and imaging services furnished by a 
 freestanding emergency center in connection with specified 
 emergency services (as such terms are defined in 

section 1861

    (nnn) ).''.

    (g) 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 Act.
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