Health Care Safety Net Enhancement Act of 2019

I 116TH CONGRESS 1ST SESSION H. R. 3984 To improve access to emergency medical services, and for other purposes. IN THE HOUSE OF REPRESENTATIVES JULY 25, 2019 Mr. FLORES (for himself, Mr. MARSHALL, and Mr. BABIN) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To improve access to emergency medical services, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Health Care Safety 4 Net Enhancement Act of 2019’’. 5 SEC. 2. CONSTITUTIONAL AUTHORITY. 6 The constitutional authority upon which this Act 7 rests is the power of the Congress to provide for the gen- 8 eral welfare, to regulate commerce, and to make all laws 9 which shall be necessary and proper for carrying into exe- 10 VerDate Sep 11 2014 00:08 Aug 13, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3984.IH H3984 kjohnson on DSK79L0C42 with BILLS 2 •HR 3984 IH cution Federal powers, as enumerated in section 8 of arti- 1 cle I of the Constitution of the United States. 2 SEC. 3. PROTECTION FOR EMERGENCY AND RELATED 3 SERVICES FURNISHED PURSUANT TO 4 EMTALA. 5 Section 224(g) of the Public Health Service Act (42 6 U.S.C. 233(g)) is amended— 7 (1) in paragraph (4), by striking ‘‘An entity’’ 8 and inserting ‘‘Subject to paragraph (6), an entity’’; 9 and 10 (2) by adding at the end the following: 11 ‘‘(6)(A) For purposes of this section— 12 ‘‘(i) an entity described in subparagraph (B) 13 shall be considered to be an entity described in para- 14 graph (4); and 15 ‘‘(ii) the provisions of this section shall apply to 16 an entity described in subparagraph (B) in the same 17 manner as such provisions apply to an entity de- 18 scribed in paragraph (4), except that— 19 ‘‘(I) notwithstanding paragraph (1)(B), the 20 deeming of any entity described in subpara- 21 graph (B), or of an officer, governing board 22 member, employee, contractor, or on-call pro- 23 vider of such an entity, to be an employee of 24 the Public Health Service for purposes of this 25 VerDate Sep 11 2014 00:08 Aug 13, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3984.IH H3984 kjohnson on DSK79L0C42 with BILLS 3 •HR 3984 IH section shall apply only with respect to items 1 and services that are furnished to an individual 2 pursuant to section 1867 of the Social Security 3 Act and to post stabilization services (as de- 4 fined in subparagraph (D)) furnished to such 5 an individual; 6 ‘‘(II) nothing in paragraph (1)(D) shall be 7 construed as preventing a physician or physi- 8 cian group described in subparagraph (B)(ii) 9 from making the application referred to in such 10 paragraph or as conditioning the deeming of a 11 physician or physician group that makes such 12 an application upon receipt by the Secretary of 13 an application from the hospital or emergency 14 department that employs or contracts with the 15 physician or group, or enlists the physician or 16 physician group as an on-call provider; 17 ‘‘(III) notwithstanding paragraph (3), this 18 paragraph shall apply only with respect to 19 causes of action arising from acts or omissions 20 that occur on or after the date that is 6 months 21 after the date of enactment of this paragraph; 22 ‘‘(IV) paragraph (5) shall not apply to a 23 physician or physician group described in sub- 24 paragraph (B)(ii); 25 VerDate Sep 11 2014 00:08 Aug 13, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3984.IH H3984 kjohnson on DSK79L0C42 with BILLS 4 •HR 3984 IH ‘‘(V) the Attorney General, in consultation 1 with the Secretary, shall make separate esti- 2 mates under subsection (k)(1) with respect to 3 entities described in subparagraph (B) and enti- 4 ties described in paragraph (4) (other than 5 those described in subparagraph (B)), and the 6 Secretary shall establish separate funds under 7 subsection (k)(2) with respect to such groups of 8 entities, and any appropriations under this sub- 9 section for entities described in subparagraph 10 (B) shall be separate from the amounts author- 11 ized by subsection (k)(2); 12 ‘‘(VI) notwithstanding subsection (k)(2), 13 the amount of the fund established by the Sec- 14 retary under such subsection with respect to en- 15 tities described in subparagraph (B) may ex- 16 ceed a total of $10,000,000 for a fiscal year; 17 and 18 ‘‘(VII) subsection (m) shall not apply to 19 entities described in subparagraph (B). 20 ‘‘(B) An entity described in this subparagraph is— 21 ‘‘(i) a hospital or an emergency department to 22 which section 1867 of the Social Security Act ap- 23 plies; and 24 VerDate Sep 11 2014 00:08 Aug 13, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3984.IH H3984 kjohnson on DSK79L0C42 with BILLS 5 •HR 3984 IH ‘‘(ii) a physician or physician group that is em- 1 ployed by, is under contract with, or is an on-call 2 provider of such hospital or emergency department, 3 to furnish items and services to individuals under 4 such section. 5 ‘‘(C) For purposes of this paragraph, the term ‘on- 6 call provider’ means a physician or physician group that— 7 ‘‘(i) has full, temporary, or locum tenens staff 8 privileges at a hospital or emergency department to 9 which section 1867 of the Social Security Act ap- 10 plies; and 11 ‘‘(ii) is not employed by or under contract with 12 such hospital or emergency department, but agrees 13 to be ready and available to provide services pursu- 14 ant to section 1867 of the Social Security Act or 15 post stabilization services to individuals being treat- 16 ed in the hospital or emergency department with or 17 without compensation from the hospital or emer- 18 gency department. 19 ‘‘(D) For purposes of this paragraph, the term ‘post 20 stabilization services’ means, with respect to an individual 21 who has been treated by an entity described in subpara- 22 graph (B) for purposes of complying with section 1867 23 of the Social Security Act, services that are— 24 VerDate Sep 11 2014 00:08 Aug 13, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3984.IH H3984 kjohnson on DSK79L0C42 with BILLS 6 •HR 3984 IH ‘‘(i) related to the condition that was so treated; 1 and 2 ‘‘(ii) provided after the individual is stabilized 3 in order to maintain the stabilized condition or to 4 improve or resolve the condition of the individual. 5 ‘‘(E)(i) Nothing in this paragraph (or in any other 6 provision of this section as such provision applies to enti- 7 ties described in subparagraph (B) by operation of sub- 8 paragraph (A)) shall be construed as authorizing or re- 9 quiring the Secretary to make payments to such entities, 10 the budget authority for which is not provided in advance 11 by appropriation Acts. 12 ‘‘(ii) The Secretary shall limit the total amount of 13 payments under this paragraph for a fiscal year to the 14 total amount appropriated in advance by appropriation 15 Acts for such purpose for such fiscal year. If the total 16 amount of payments that would otherwise be made under 17 this paragraph for a fiscal year exceeds such total amount 18 appropriated, the Secretary shall take such steps as may 19 be necessary to ensure that the total amount of payments 20 under this paragraph for such fiscal year does not exceed 21 such total amount appropriated.’’. 22 Æ VerDate Sep 11 2014 00:08 Aug 13, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\H3984.IH H3984 kjohnson on DSK79L0C42 with BILLS