H.R.836 – Health Care Safety Net Enhancement Act of 2015

From Congress.gov:

[Congressional Bills 114th Congress]
[From the U.S. Government Printing Office]
[H.R. 836 Introduced in House (IH)]

114th CONGRESS
  1st Session
                                H. R. 836

    To improve access to emergency medical services, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 10, 2015

  Mr. Dent (for himself, Mr. Wilson of South Carolina, Mr. Ruiz, Mr. 
Harris, Mr. Gibson, Mr. Benishek, Mr. Joyce, Mr. Gosar, Mr. Hanna, Mr. 
      Ribble, Mr. Roskam, Mr. Langevin, Mr. Harper, Mr. Kelly of 
   Pennsylvania, Mr. Ruppersberger, Mr. Barr, Mr. Olson, Mr. Roe of 
   Tennessee, Mr. Sessions, Mr. Murphy of Pennsylvania, Mr. Heck of 
   Nevada, Mr. McKinley, Mr. Jolly, and Mr. Boustany) 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 Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Health Care Safety Net Enhancement 
Act of 2015''.

SEC. 2. CONSTITUTIONAL AUTHORITY.

    The constitutional authority upon which this Act rests is the power 
of the Congress to provide for the general welfare, to regulate 
commerce, and to make all laws which shall be necessary and proper for 
carrying into execution Federal powers, as enumerated in section 8 of 
article I of the Constitution of the United States.

SEC. 3. PROTECTION FOR EMERGENCY AND RELATED SERVICES FURNISHED 
              PURSUANT TO EMTALA.

    Section 224(g) of the Public Health Service Act (42 U.S.C. 233(g)) 
is amended--
            (1) in paragraph (4), by striking ``An entity'' and 
        inserting ``Subject to paragraph (6), an entity''; and
            (2) by adding at the end the following:
            ``(6)(A) For purposes of this section--
                    ``(i) an entity described in subparagraph (B) shall 
                be considered to be an entity described in paragraph 
                (4); and
                    ``(ii) the provisions of this section shall apply 
                to an entity described in subparagraph (B) in the same 
                manner as such provisions apply to an entity described 
                in paragraph (4), except that--
                            ``(I) notwithstanding paragraph (1)(B), the 
                        deeming of any entity described in subparagraph 
                        (B), or of an officer, governing board member, 
                        employee, contractor, or on-call provider of 
                        such an entity, to be an employee of the Public 
                        Health Service for purposes of this section 
                        shall apply only with respect to items and 
                        services that are furnished to an individual 
                        pursuant to section 1867 of the Social Security 
                        Act and to post stabilization services (as 
                        defined in subparagraph (D)) furnished to such 
                        an individual;
                            ``(II) nothing in paragraph (1)(D) shall be 
                        construed as preventing a physician or 
                        physician group described in subparagraph 
                        (B)(ii) from making the application referred to 
                        in such paragraph or as conditioning the 
                        deeming of a physician or physician group that 
                        makes such an application upon receipt by the 
                        Secretary of an application from the hospital 
                        or emergency department that employs or 
                        contracts with the physician or group, or 
                        enlists the physician or physician group as an 
                        on-call provider;
                            ``(III) notwithstanding paragraph (3), this 
                        paragraph shall apply only with respect to 
                        causes of action arising from acts or omissions 
                        that occur on or after January 1, 2016;
                            ``(IV) paragraph (5) shall not apply to a 
                        physician or physician group described in 
                        subparagraph (B)(ii);
                            ``(V) the Attorney General, in consultation 
                        with the Secretary, shall make separate 
                        estimates under subsection (k)(1) with respect 
                        to entities described in subparagraph (B) and 
                        entities described in paragraph (4) (other than 
                        those described in subparagraph (B)), and the 
                        Secretary shall establish separate funds under 
                        subsection (k)(2) with respect to such groups 
                        of entities, and any appropriations under this 
                        subsection for entities described in 
                        subparagraph (B) shall be separate from the 
                        amounts authorized by subsection (k)(2);
                            ``(VI) notwithstanding subsection (k)(2), 
                        the amount of the fund established by the 
                        Secretary under such subsection with respect to 
                        entities described in subparagraph (B) may 
                        exceed a total of $10,000,000 for a fiscal 
                        year; and
                            ``(VII) subsection (m) shall not apply to 
                        entities described in subparagraph (B).
            ``(B) An entity described in this subparagraph is--
                    ``(i) a hospital or an emergency department to 
                which section 1867 of the Social Security Act applies; 
                and
                    ``(ii) a physician or physician group that is 
                employed by, is under contract with, or is an on-call 
                provider of such hospital or emergency department, to 
                furnish items and services to individuals under such 
                section.
            ``(C) For purposes of this paragraph, the term `on-call 
        provider' means a physician or physician group that--
                    ``(i) has full, temporary, or locum tenens staff 
                privileges at a hospital or emergency department to 
                which section 1867 of the Social Security Act applies; 
                and
                    ``(ii) is not employed by or under contract with 
                such hospital or emergency department, but agrees to be 
                ready and available to provide services pursuant to 
                section 1867 of the Social Security Act or post 
                stabilization services to individuals being treated in 
                the hospital or emergency department with or without 
                compensation from the hospital or emergency department.
            ``(D) For purposes of this paragraph, the term `post 
        stabilization services' means, with respect to an individual 
        who has been treated by an entity described in subparagraph (B) 
        for purposes of complying with section 1867 of the Social 
        Security Act, services that are--
                    ``(i) related to the condition that was so treated; 
                and
                    ``(ii) provided after the individual is stabilized 
                in order to maintain the stabilized condition or to 
                improve or resolve the condition of the individual.
            ``(E)(i) Nothing in this paragraph (or in any other 
        provision of this section as such provision applies to entities 
        described in subparagraph (B) by operation of subparagraph (A)) 
        shall be construed as authorizing or requiring the Secretary to 
        make payments to such entities, the budget authority for which 
        is not provided in advance by appropriation Acts.
            ``(ii) The Secretary shall limit the total amount of 
        payments under this paragraph for a fiscal year to the total 
        amount appropriated in advance by appropriation Acts for such 
        purpose for such fiscal year. If the total amount of payments 
        that would otherwise be made under this paragraph for a fiscal 
        year exceeds such total amount appropriated, the Secretary 
        shall take such steps as may be necessary to ensure that the 
        total amount of payments under this paragraph for such fiscal 
        year does not exceed such total amount appropriated.''.
                                 <all>

As Rural Hospitals Die, Local Communities Suffer

From Sound Medicine News:

Sound Medicine: What are some of the factors that threaten a small hospital’s survival prospects compared to a larger counterpart in a big city?

Daniel Derksen: First of all, rural hospitals are really a central strand in our nation’s healthcare safety net. These communities depend on this health infrastructure to provide health services and ready access to care for individuals that live in those communities. They’re really the foundation for community and create jobs and catalyze economic development, as well as provide access to high-quality care.

But right now our health system in the country is undergoing dramatic transformation. There are a lot of opportunities for rural hospitals, as well as challenges. I’d say one of the challenges is a shortage of healthcare providers in small towns, at the same time that many more people are being covered by the provisions of the Affordable Care Act such as expanded Medicaid, and by the healthcare marketplaces,

And we’re seeing the way that hospitals are being paid is changing very quickly. In the past it’s been dominated by receiving a payment or a fee every time a service is provided. The system is rapidly changing to payment for health outcomes. There’s an expectation now of not only performing a service, but a high quality outcome.

Emergency Physicians to begin making ‘house calls’

From Hometown Life:

Starting this spring, emergency physicians from St. Joseph Mercy Oakland will begin making ‘house calls’ in Bloomfield Township.

The physicians won’t be on the scene, but they’ll be able to consult patients through encrypted, HIPAA-secure computer tablets that are being provided to 57 township paramedics. The collaborative pilot program is the first-of-its-kind in the state of Michigan.

“It’s almost like video conferencing,” Bloomfield Township Fire Chief Dave Piche said Thursday. “We’re essentially bringing the doctor to the scene so the patients don’t have to leave their houses.”