< Back to H.R. 859 (104th Congress, 1995–1996)

Text of the Rural Emergency Access Care Hospital Act of 1995

This bill was introduced on February 8, 1995, in a previous session of Congress, but was not enacted. The text of the bill below is as of Feb 8, 1995 (Introduced).

Download PDF

Source: GPO

HR 859 IH

104th CONGRESS

1st Session

H. R. 859

To amend title XVIII of the Social Security Act to provide for coverage under part B of the medicare program of emergency care and related services furnished by rural emergency access care hospitals.

IN THE HOUSE OF REPRESENTATIVES

February 8, 1995

Mr. GUNDERSON introduced the following bill; which was referred to the Committee on 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 title XVIII of the Social Security Act to provide for coverage under part B of the medicare program of emergency care and related services furnished by rural emergency access care hospitals.

    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 ‘Rural Emergency Access Care Hospital Act of 1995’.

SEC. 2. RURAL EMERGENCY ACCESS CARE HOSPITALS DESCRIBED.

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

‘Rural Emergency Access Care Hospital; Rural Emergency Access Care Hospital Services

    ‘(oo)(1) The term ‘rural emergency access care hospital’ means, for a fiscal year, a facility with respect to which the Secretary finds the following:

      ‘(A) The facility is located in a rural area (as defined in section 1886(d)(2)(D)).

      ‘(B) The facility was a hospital under this title at any time during the 5-year period that ends on the date of the enactment of this subsection.

      ‘(C) The facility is in danger of closing due to low inpatient utilization rates and negative operating losses, and the closure of the facility would limit the access of individuals residing in the facility’s service area to emergency services.

      ‘(D) The facility has entered into (or plans to enter into) an agreement with a hospital with a participation agreement in effect under section 1866(a), and under such agreement the hospital shall accept patients transferred to the hospital from the facility and receive data from and transmit data to the facility.

      ‘(E) There is a practitioner who is qualified to provide advanced cardiac life support services (as determined by the State in which the facility is located) on-site at the facility on a 24-hour basis.

      ‘(F) A physician is available on-call to provide emergency medical services on a 24-hour basis.

      ‘(G) The facility meets such staffing requirements as would apply under section 1861(e) to a hospital located in a rural area, except that--

        ‘(i) the facility need not meet hospital standards relating to the number of hours during a day, or days during a week, in which the facility must be open, except insofar as the facility is required to provide emergency care on a 24-hour basis under subparagraphs (E) and (F); and

        ‘(ii) the facility may provide any services otherwise required to be provided by a full-time, on-site dietician, pharmacist, laboratory technician, medical technologist, or radiological technologist on a part time, off-site basis.

      ‘(H) The facility meets the requirements applicable to clinics and facilities under subparagraphs (C) through (J) of paragraph (2) of section 1861(aa) and of clauses (ii) and (iv) of the second sentence of such paragraph (or, in the case of the requirements of subparagraph (E), (F), or (J) of such paragraph, would meet the requirements if any reference in such subparagraph to a ‘nurse practitioner’ or to ‘nurse practitioners’ was deemed to be a reference to a ‘nurse practitioner or nurse’ or to ‘nurse practitioners or nurses’); except that in determining whether a facility meets the requirements of this subparagraph, subparagraphs (E) and (F) of that paragraph shall be applied as if any reference to a ‘physician’ is a reference to a physician as defined in section 1861(r)(1).

    ‘(2) The term ‘rural emergency access care hospital services’ means the following services provided by a rural emergency access care hospital:

      ‘(A) An appropriate medical screening examination (as described in section 1867(a)).

      ‘(B) Necessary stabilizing examination and treatment services for an emergency medical condition and labor (as described in section 1867(b)).’.

    (b) REQUIRING RURAL EMERGENCY ACCESS CARE HOSPITALS TO MEET HOSPITAL ANTI-DUMPING REQUIREMENTS- Section 1867(e)(5) of such Act (42 U.S.C. 1395dd(e)(5)) is amended by striking ‘1861(mm)(1))’ and inserting ‘1861(mm)(1)) and a rural emergency access care hospital (as defined in section 1861(oo)(1))’.

SEC. 3. COVERAGE OF AND PAYMENT FOR SERVICES.

    (a) COVERAGE UNDER PART B- Section 1832(a)(2) of the Social Security Act (42 U.S.C. 1395k(a)(2)) is amended--

      (1) by striking ‘and’ at the end of subparagraph (I);

      (2) by striking the period at the end of subparagraph (J) and inserting ‘; and’; and

      (3) by adding at the end the following new subparagraph:

        ‘(K) rural emergency access care hospital services (as defined in section 1861(oo)(2)).’.

    (b) PAYMENT BASED ON PAYMENT FOR OUTPATIENT RURAL PRIMARY CARE HOSPITAL SERVICES-

      (1) IN GENERAL- Section 1833(a)(6) of the Social Security Act (42 U.S.C. 1395l(a)(6)) is amended by striking ‘services,’ and inserting ‘services and rural emergency access care hospital services,’.

      (2) PAYMENT METHODOLOGY DESCRIBED- Section 1834(g) of such Act (42 U.S.C. 1395m(g)) is amended--

        (A) in the heading, by striking ‘SERVICES’ and inserting ‘SERVICES AND RURAL EMERGENCY ACCESS CARE HOSPITAL SERVICES’; and

        (B) by adding at the end the following new paragraph:

      ‘(3) APPLICATION OF METHODS TO PAYMENT FOR RURAL EMERGENCY ACCESS CARE HOSPITAL SERVICES- The amount of payment for rural emergency access care hospital services provided during a year shall be determined using the applicable method provided under this subsection for determining payment for outpatient rural primary care hospital services during the year.’.

SEC. 4. EFFECTIVE DATE.

    The amendments made by this Act shall apply to fiscal years beginning on or after October 1, 1995.