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