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<bill bill-stage="Introduced-in-Senate" public-private="public">
	<metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
<dublinCore>
<dc:title>113 S328 IS: Strengthening Rural Access to Emergency Services Act</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2013-02-14</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
</dublinCore>
</metadata>
<form>
		<distribution-code display="yes">II</distribution-code>
		<congress>113th CONGRESS</congress>
		<session>1st Session</session>
		<legis-num>S. 328</legis-num>
		<current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber>
		<action>
			<action-date date="20130214">February 14, 2013</action-date>
			<action-desc><sponsor name-id="S303">Mr. Thune</sponsor> (for himself,
			 <cosponsor name-id="S326">Mr. Udall of New Mexico</cosponsor>, and
			 <cosponsor name-id="S330">Mr. Bennet</cosponsor>) introduced the following
			 bill; which was read twice and referred to the
			 <committee-name committee-id="SSFI00">Committee on
			 Finance</committee-name></action-desc>
		</action>
		<legis-type>A BILL</legis-type>
		<official-title>To amend title XVIII of the Social Security Act to allow
		  certain critical access hospitals and sole community hospitals to use
		  interactive telecommunications systems to satisfy requirements with respect to
		  having a physician available to stabilize an individual with an emergency
		  medical condition under the Medicare program.</official-title>
	</form>
	<legis-body>
		<section id="S1" section-type="section-one"><enum>1.</enum><header>Short
			 title</header><text display-inline="no-display-inline">This Act may be cited as
			 the <quote><short-title>Strengthening Rural Access to
			 Emergency Services Act</short-title></quote>.</text>
		</section><section id="id9312624AA19745F8B3E331A602B6926A"><enum>2.</enum><header>Allowing certain
			 critical access hospitals and sole community hospitals to use interactive
			 telecommunications systems to satisfy requirements with respect to having a
			 physician available to stabilize an individual with an emergency medical
			 condition</header>
			<subsection id="id5D2C1AC80091483EB8CF8CD892D70D1B"><enum>(a)</enum><header>In
			 general</header><text display-inline="yes-display-inline">Section 1866(a) of
			 the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395cc">42 U.S.C. 1395cc(a)</external-xref>) is amended—</text>
				<paragraph id="id1D25A6E35D114B49A3167B16124FE59C"><enum>(1)</enum><text display-inline="yes-display-inline">in paragraph (1)(I)(iii), by inserting
			 <quote>(subject to paragraph (4))</quote> after <quote>on call for
			 duty</quote>; and</text>
				</paragraph><paragraph id="idDFA2577618B64CEB90DCB36297737CE7"><enum>(2)</enum><text display-inline="yes-display-inline">by adding at the end the following new
			 paragraph:</text>
					<quoted-block display-inline="no-display-inline" id="id4BBD350B5B2844C8AD5B0F8ED51E874B" style="OLC">
						<paragraph id="id28462D9CB5D94E19BD028E8C4F82768F" indent="up1"><enum>(4)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="id37C0E08F4B4143BC99FD74443E0C38A6"><enum>(A)</enum><text display-inline="yes-display-inline">For purposes of paragraph (1)(I)(iii) of
				this subsection and subsections (b)(1)(A) and (d)(1)(C) of section 1867,
				effective on the date of enactment of this paragraph, with respect to an
				applicable critical access hospital or applicable sole community hospital, a
				physician is considered on call for duty under such paragraph, available to
				provide further medical examination and treatment necessary to stabilize an
				individual with an emergency medical condition under such subsection (b)(1)(A),
				and to have appeared under such subsection (d)(1)(C), if the physician is
				available—</text>
								<clause id="id5F4C202C762A4040845FC8B0F2C0DEFB" indent="up1"><enum>(i)</enum><text display-inline="yes-display-inline">in
				person; or</text>
								</clause><clause id="id36A3103C313141BB9286F65E33648173" indent="up1"><enum>(ii)</enum><text display-inline="yes-display-inline">subject to subparagraph (B), by interactive
				telecommunications system (as defined in <external-xref legal-doc="usc" parsable-cite="usc/42/410">section 410.78(a)(3)</external-xref> of title 42, Code
				of Federal Regulations).</text>
								</clause></subparagraph><subparagraph id="id089DC5D0B2414E57B6EBBC14A95C7BCF" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">Subparagraph (A)(ii) shall only apply
				if—</text>
								<clause id="id9E816E60CFBC456E820DC4066EDCEE8B"><enum>(i)</enum><text display-inline="yes-display-inline">the physician available by such interactive
				telecommunications system is board certified in emergency medicine or pediatric
				emergency medicine; and</text>
								</clause><clause id="id5C682BDF75DF42BCB5803CB709F564F8"><enum>(ii)</enum><text display-inline="yes-display-inline">a
				nurse practitioner or physician assistant (as those terms are defined in
				section 1861(aa)(5)) is onsite in the emergency department.</text>
								</clause></subparagraph><subparagraph id="idF4018D6967B24ACCA16929463ECB1D37" indent="up1"><enum>(C)</enum><text display-inline="yes-display-inline">In this paragraph:</text>
								<clause id="idD9CF13CB5FCE40699BCE91E35F460FE9"><enum>(i)</enum><text display-inline="yes-display-inline">The term <term>applicable critical access
				hospital</term> means a critical access hospital (as defined in section
				1861(mm)(1)) located—</text>
									<subclause id="id0A26616E0F154BA88470BB4D469CB35F"><enum>(I)</enum><text display-inline="yes-display-inline">in an area that is designated as a rural
				health professional shortage area under section 332(a)(1)(A) of the Public
				Health Service Act; and</text>
									</subclause><subclause id="idC4330A70D88C43199BC3E0BA5324CCA7"><enum>(II)</enum><text display-inline="yes-display-inline">in a county that is not included in a
				Metropolitan Statistical area.</text>
									</subclause></clause><clause id="idBC10CE0C551C4645AC4C2EAB8D271818"><enum>(ii)</enum><text display-inline="yes-display-inline">The term <term>applicable sole community
				hospital</term> means a sole community hospital (as defined in section
				1886(d)(5)(D)(iii)) that—</text>
									<subclause id="idCD929DB292F24E88A1E475AC591CC96A"><enum>(I)</enum><text display-inline="yes-display-inline">has less than 50 beds;</text>
									</subclause><subclause id="id978772E7C6FD491FA965AF93F804B4C7"><enum>(II)</enum><text display-inline="yes-display-inline">has an emergency department; and</text>
									</subclause><subclause id="id9913DCEEB9A3496F864BB933C9716E0C"><enum>(III)</enum><text display-inline="yes-display-inline">is located—</text>
										<item id="idD96375F9A0D24B759DA654ED0AFC209A"><enum>(aa)</enum><text display-inline="yes-display-inline">in
				an area that is designated as a rural health professional shortage area under
				section 332(a)(1)(A) of the Public Health Service Act; and</text>
										</item><item id="idB690E67C41C74955AB28D67BB704BAE3"><enum>(bb)</enum><text display-inline="yes-display-inline">in a
				county that is not included in a Metropolitan Statistical
				Area.</text>
										</item></subclause></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
				</paragraph></subsection><subsection id="id8EE7F45076CB4F12A1F26D25E32AB5FC"><enum>(b)</enum><header>Conforming
			 amendments</header><text>Section 1867 of the Social Security Act (42 U.S.C.
			 1395dd) is amended—</text>
				<paragraph id="idE3271890111A4399A560156D0F1DA3DF"><enum>(1)</enum><text>in subsection
			 (b)(1)(A), by inserting <quote>(determined in accordance with section
			 1866(a)(4))</quote> after <quote>hospital</quote>; and</text>
				</paragraph><paragraph id="id98D3BAC875E94098B7A6CEADFC5291EB"><enum>(2)</enum><text>in subsection
			 (d)(1)(C), in the first sentence, by inserting <quote>(determined in accordance
			 with section 1866(a)(4))</quote> after <quote>refuses to appear</quote>.</text>
				</paragraph></subsection></section></legis-body>
</bill>


