RESEARCH Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 5727 To provide for a study by the National Academy of Medicine on ambulance diversions, and for other purposes. IN THE HOUSE OF REPRESENTATIVES JANUARY 30, 2020 Mr. RUSH (for himself, Mr. THOMPSON of Mississippi, Mrs. WATSON COLE- MAN, and Ms. BARRAGA´N) introduced the following bill; which was re- ferred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently de- termined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To provide for a study by the National Academy of Medicine on ambulance diversions, 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 ‘‘Research Empirical 4 Solutions to End Ambulance Reversals from Closed Hos- 5 pitals Act of 2020’’ or the ‘‘RESEARCH Act of 2020’’. 6 VerDate Sep 11 2014 01:31 Feb 01, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H5727.IH H5727 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 5727 IH SEC. 2. STUDY ON AMBULANCE DIVERSIONS. 1 (a) STUDY.—The Secretary of Health and Human 2 Services shall seek to enter into an agreement with the 3 National Academy of Medicine under which the National 4 Academy agrees to conduct a study on ambulance diver- 5 sions, including— 6 (1) whether the number of such diversions have 7 increased over the last 10 years, including whether 8 the number of such diversions have increased at the 9 national, regional, State, and local level; 10 (2) what steps, if any, have been taken to re- 11 duce the number of such diversions; 12 (3) whether such diversions disproportionately 13 impact medically underserved communities (as de- 14 fined in section 799B of the Public Health Service 15 Act (42 U.S.C. 295p)); and 16 (4) what actions the Federal Government 17 should take— 18 (A) to reduce the number of ambulance di- 19 versions; and 20 (B) to improve the health and safety of pa- 21 tients affected by ambulance diversions. 22 (b) CONSULTATION.—The agreement under sub- 23 section (a) shall require the study under such agreement 24 to be conducted in consultation with— 25 VerDate Sep 11 2014 01:31 Feb 01, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H5727.IH H5727 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 5727 IH (1) the Assistant Secretary for Planning and 1 Evaluation of the Department of Health and Human 2 Services; 3 (2) the Assistant Secretary for Preparedness 4 and Response of the Department of Health and 5 Human Services; and 6 (3) the Director of the Office of Emergency 7 Care Research of the National Institutes of Health. 8 (c) REPORT.—The agreement under subsection (a) 9 shall provide for— 10 (1) the submission to the congressional commit- 11 tees of jurisdiction, not later than 24 months after 12 the date of enactment of this Act, of a report on the 13 results of the study under such agreement; and 14 (2) the inclusion in such report of recommenda- 15 tions on actions the Federal Government should 16 take— 17 (A) to mitigate the occurrence of ambu- 18 lance diversions; and 19 (B) to improve the health and safety of pa- 20 tients affected by ambulance diversions. 21 (d) DEFINITION.—In this section, the term ‘‘ambu- 22 lance diversion’’ means the temporary closure of a hospital 23 emergency department to incoming ambulances. 24 VerDate Sep 11 2014 01:31 Feb 01, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H5727.IH H5727 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 5727 IH SEC. 3. HOSPITAL REPORTING REQUIREMENT. 1 (a) REPORTING REQUIREMENT.—A hospital shall re- 2 port to the Secretary of Health and Human Services, in 3 the case the hospital implements an ambulance diversion 4 on or after January 1, 2021— 5 (1) how long the diversion was in effect; 6 (2) the reason for the diversion; and 7 (3) the number of ambulance calls the hospital 8 diverted while the diversion was in effect. 9 (b) ENFORCEMENT.— 10 (1) HOSPITALS.—Section 1886(d)(5) of the So- 11 cial Security Act (42 U.S.C. 1395ww(d)(5)) is 12 amended by adding at the end the following new 13 subparagraph: 14 ‘‘(M)(i)(I) In the case that the Secretary determines, 15 with respect to a calendar quarter occurring in the period 16 beginning with 2021 and ending with 2024, that a hospital 17 has complied with the provisions of section 3(a) of the RE- 18 SEARCH Act of 2020 with respect to each ambulance di- 19 version (if any) that occurred during such quarter, the 20 Secretary shall increase, by the percentage specified in 21 subclause (II) for such quarter, the amount otherwise pay- 22 able to such hospital under paragraph (1)(A) for dis- 23 charges occurring in the succeeding quarter. 24 VerDate Sep 11 2014 01:31 Feb 01, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5727.IH H5727 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 5727 IH ‘‘(II) For purposes of subclause (I), the percentage 1 specified in this subclause is, with respect to a calendar 2 quarter occurring in— 3 ‘‘(aa) 2021 or 2022, 1 percent; or 4 ‘‘(bb) 2023 or 2024, 0.5 percent. 5 ‘‘(ii)(I) In the case that the Secretary determines, 6 with respect to a calendar quarter occurring in 2025 or 7 a subsequent year, that a hospital has failed to report an 8 ambulance diversion occurring during such quarter to the 9 Secretary in accordance with section 3(a) of the RE- 10 SEARCH Act of 2020, the Secretary shall reduce, by the 11 percentage specified in subclause (II) for such quarter, the 12 amount otherwise payable to such hospital under para- 13 graph (1)(A) for discharges occurring in the succeeding 14 quarter. 15 ‘‘(II) For purposes of subclause (I), the percentage 16 specified in this subclause is, with respect to a calendar 17 quarter occurring in— 18 ‘‘(aa) 2025, 1 percent; or 19 ‘‘(bb) 2026 or a subsequent year, 2 percent. 20 ‘‘(iii) In this subparagraph, the term ‘ambulance di- 21 version’ has the meaning given such term in section 2 of 22 the RESEARCH Act of 2020.’’. 23 (2) CRITICAL ACCESS HOSPITALS.—Section 24 1814(l) of the Social Security Act (42 U.S.C. 25 VerDate Sep 11 2014 01:31 Feb 01, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H5727.IH H5727 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 5727 IH 1395f(l)) is amended by adding at the end the fol- 1 lowing new paragraph: 2 ‘‘(6)(A)(i) In the case that the Secretary determines, 3 with respect to a calendar quarter occurring in the period 4 beginning with 2021 and ending with 2024, that a critical 5 access hospital has complied with the provisions of section 6 3(a) of the RESEARCH Act of 2020 with respect to each 7 ambulance diversion (if any) that occurred during such 8 quarter, the Secretary shall increase, by the percentage 9 specified in clause (ii) for such quarter, the amount other- 10 wise payable to such hospital under paragraph (1) for 11 services furnished during the succeeding quarter. 12 ‘‘(ii) For purposes of clause (i), the percentage speci- 13 fied in this clause is, with respect to a calendar quarter 14 occurring in— 15 ‘‘(I) 2021 or 2022, 1 percent; or 16 ‘‘(II) 2023 or 2024, 0.5 percent. 17 ‘‘(B)(i) In the case that the Secretary determines, 18 with respect to a calendar quarter occurring in 2025 or 19 a subsequent year, that a critical access hospital has failed 20 to report an ambulance diversion occurring during such 21 quarter to the Secretary in accordance with section 3(a) 22 of the RESEARCH Act of 2020, the Secretary shall re- 23 duce, by the percentage specified in clause (ii) for such 24 quarter, the amount otherwise payable to such hospital 25 VerDate Sep 11 2014 01:31 Feb 01, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H5727.IH H5727 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 5727 IH under paragraph (1) for services furnished during the suc- 1 ceeding quarter. 2 ‘‘(ii) For purposes of clause (i), the percentage speci- 3 fied in this clause is, with respect to a calendar quarter 4 occurring in— 5 ‘‘(I) 2025, 1 percent; or 6 ‘‘(II) 2026 or a subsequent year, 2 percent.’’. 7 (c) DEFINITION.—In this section: 8 (1) The term ‘‘ambulance diversion’’ has the 9 meaning given to such term in section 2. 10 (2) The term ‘‘hospital’’ means a subsection (d) 11 hospital (as defined in section 1886(d)(1)(B) of the 12 Social Security Act (42 U.S.C. 1395ww(d)(1)(B))), 13 or a critical access hospital (as defined in section 14 1861(mm) of such Act (42 U.S.C. 1395x(mm))), en- 15 rolled under section 1866(j) of such Act (42 U.S.C. 16 1392cc(j)). 17 Æ VerDate Sep 11 2014 01:31 Feb 01, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\H5727.IH H5727 pamtmann on DSKBC07HB2PROD with BILLS