1.Short title; table of contents
(a)This Act may be cited as the
Access to Emergency Medical Services
Act of 2009
.
(b)The table of contents of this Act is as
follows:
Sec. 1. Short title;
table of contents.
TITLE I—Bipartisan commission on access to emergency medical
services
Sec. 101.
Establishment.
Sec. 102. Duties.
Sec. 103.
Membership.
Sec. 104. Staff and
consultants.
Sec. 105. Powers.
Sec. 106. Report on
ways to promote the effective delivery of emergency medical
services.
Sec. 107.
Termination.
Sec. 108.
Authorization of appropriations.
TITLE II—Additional
payments for certain physicians’ services
Sec. 201. Additional
payments for certain physicians’ services.
TITLE III—Centers for Medicare & Medicaid Services Working
Group to improve emergency care efficiency
Sec. 301. Centers for
Medicare & Medicaid Services Working Group to improve emergency care
efficiency.
<enum>I</enum><header display-inline="yes-display-inline">Bipartisan commission on access to
emergency medical services</header>
<section commented="no" display-inline="no-display-inline" id="HAA2F0EAD2A7F4AAA870091670494119C" section-type="subsequent-section"><enum>101.</enum><header display-inline="yes-display-inline">Establishment</header><text display-inline="no-display-inline">There is established the United States
Bipartisan Commission on Access to Emergency Medical Services (in this title
referred to as the “Commission”).</text>
</section><section commented="no" display-inline="no-display-inline" id="HCC33429309484E0ABABB7124F96A2B8" section-type="subsequent-section"><enum>102.</enum><header display-inline="yes-display-inline">Duties</header>
<subsection commented="no" display-inline="no-display-inline" id="H6F5073EDCA0244ADA6299F482000FFA2"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The Commission shall perform the following
duties:</text>
<paragraph commented="no" display-inline="no-display-inline" id="HD6691EFFE4DE4D5C9148BD1E5063722F"><enum>(1)</enum><text display-inline="yes-display-inline">Identify and examine factors (including
factors described in subsection (b)) in the health care delivery, financing,
and legal systems that affect the effective delivery of screening and
stabilization services furnished in hospitals that have emergency departments
pursuant to EMTALA.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HF34EC61119EE4E3CBA20432FFFB00E7"><enum>(2)</enum><text display-inline="yes-display-inline">Make specific recommendations to Congress,
taking into account the considerations specified in subsection (c), with
respect to Federal programs, policies, and financing needed to assure the
availability of such screening and stabilization services and the coordination
of State, local, and Federal programs for responding to disasters and
emergencies.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H4066B4E1451C45F0998B4D137CC7E98"><enum>(b)</enum><header display-inline="yes-display-inline">Factors considered</header><text display-inline="yes-display-inline">For purposes of subsection (a)(1), the
Commission shall examine at least the following factors, with respect to
emergency departments of hospitals:</text>
<paragraph commented="no" display-inline="no-display-inline" id="HFA3D3AC6827549C08FFB9ED2EB3F808D"><enum>(1)</enum><text display-inline="yes-display-inline">Crowded conditions in such emergency
departments and the practice of boarding patients who require admission, or
have already been admitted, to a hospital for extended periods in such
departments and in the areas adjacent to such departments.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H7342D377F1B04A4EA6A79F03C3CF5225"><enum>(2)</enum><text display-inline="yes-display-inline">With respect to individuals who present at
such emergency departments for the treatment of emergency medical conditions,
any barriers that impede access within a reasonable period of time to
screening, stabilization services, and other appropriate consultations of
physicians listed by the hospital on its list of on-call physicians.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H6618B72CE37141198B666851AC00B49C"><enum>(3)</enum><text display-inline="yes-display-inline">The potential legal and financial liability
of health care professionals and providers with respect to services required to
be furnished to patients under EMTALA, relating to the requirement of emergency
departments to screen and appropriately treat or transfer individuals
presenting themselves at the departments with emergency medical conditions and
women in labor.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HE88411E5ACE14D86A146029C00EBA7C8"><enum>(c)</enum><header display-inline="yes-display-inline">Considerations in
recommendations</header><text display-inline="yes-display-inline">In making
recommendations under subsection (a)(2), the Commission shall consider the
following:</text>
<paragraph commented="no" display-inline="no-display-inline" id="H02BF65B1E59D4594911617D462E61C5D"><enum>(1)</enum><text display-inline="yes-display-inline">Any changes in Federal law that would be
necessary to promote the effective delivery of emergency medical
services.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H3D1729A3D64C437A93BA113C5BA782FB"><enum>(2)</enum><text display-inline="yes-display-inline">The amount and sources of Federal funds to
finance such changes.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H0EA848F4369842CF9BECE0BD653ECD6F"><enum>(3)</enum><text display-inline="yes-display-inline">The advantages and disadvantages of
alternative approaches to protecting health care professionals and providers
from legal and financial liability with respect to services required to be
furnished to individuals under EMTALA.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H950DE14D971D461C9F503642CF57FA9E"><enum>(4)</enum><text display-inline="yes-display-inline">The most efficient and effective manner of
coordinating State, local, and Federal programs for responding to disasters and
emergencies, with respect to the delivery of emergency medical services.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HD366F7220E0A417FA888915072D830E4"><enum>(d)</enum><header display-inline="yes-display-inline">Definitions</header><text display-inline="yes-display-inline">For purposes of this title:</text>
<paragraph commented="no" display-inline="no-display-inline" id="H908B0F3C09E2497687734EB671974168"><enum>(1)</enum><header display-inline="yes-display-inline">Hospital</header><text display-inline="yes-display-inline">The term <term>hospital</term> means a
hospital (as defined in subsection (e) of section 1861 of the Social Security
Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C.
1395x</external-xref>)) and a critical access hospital (as defined in
subsection (mm) of such section).</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HEF3BEC9444B54D2EAD22A04BAD177632"><enum>(2)</enum><header display-inline="yes-display-inline">EMTALA</header><text display-inline="yes-display-inline">The term <term>EMTALA</term> means section
1867 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395dd">42 U.S.C. 1395dd</external-xref>).</text>
</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="HA5B92725144349FA953DEAF559750614" section-type="subsequent-section"><enum>103.</enum><header display-inline="yes-display-inline">Membership</header>
<subsection commented="no" display-inline="no-display-inline" id="H27D97A043A094BA1AB93F9D06E7517E7"><enum>(a)</enum><header display-inline="yes-display-inline">Appointment</header>
<paragraph commented="no" display-inline="no-display-inline" id="H4CDFAF441EBC4CC4BD0230AB495EA6E8"><enum>(1)</enum><text display-inline="yes-display-inline">The Commission shall be composed of 24
members, who shall be appointed not later than the date that is 60 days after
the date of the enactment of this Act and in accordance with paragraph (2), as
follows:</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H6380C2227AA44C28849865341801F194"><enum>(A)</enum><text display-inline="yes-display-inline">The President shall appoint 8 members of
the Commission.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H62CCBFA7DFBD4B739F66728F5ED722A0"><enum>(B)</enum><text display-inline="yes-display-inline">The Speaker of the House of
Representatives, after consultation with the minority leader of the House of
Representatives, shall appoint 8 members of the Commission.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HABE08D5580B341BAAAD55888D2562B30"><enum>(C)</enum><text display-inline="yes-display-inline">The majority leader of the Senate, after
consultation with the minority leader of the Senate, shall appoint 8 members of
the Commission.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HE8D787865E5D4846AAFE2D889E1D5901"><enum>(2)</enum><text display-inline="yes-display-inline">Of the members appointed under paragraph
(1), the President, the Speaker of the House of Representatives, and the
majority leader of the Senate shall each appoint as members of the
commission—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H0A47C914797B4ECB898F129B4CEAB785"><enum>(A)</enum><text display-inline="yes-display-inline">two individuals who represent emergency
physicians, emergency nurses, and other health care professionals who provide
emergency medical services;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H744101B249DE42EF8BCEC9F06F356F31"><enum>(B)</enum><text display-inline="yes-display-inline">two individuals who are elected or
appointed Federal, State, or local officials and who are involved in issues and
programs related to the provision of emergency medical services;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HED68D53B070D4850AF44BB08CCB09EE9"><enum>(C)</enum><text display-inline="yes-display-inline">two health care consumer advocates;
and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id9E7E66DC8EDA4FD18935FB66378B06BF"><enum>(D)</enum><text display-inline="yes-display-inline">two individuals who represent hospitals and
health systems that provide emergency medical services.</text>
</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HF15572A226A94641B0BD89355ED32F76"><enum>(b)</enum><header display-inline="yes-display-inline">Chairperson and vice
chairperson</header><text display-inline="yes-display-inline">The Commission
shall elect a chairperson and 4 vice chairpersons from among its
members.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="HC1CFEAC0DD924B5690C97FE142BB5F27"><enum>(c)</enum><header display-inline="yes-display-inline">Terms</header><text display-inline="yes-display-inline">Each member shall be appointed for the life
of the Commission.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="HAE9FBE58B03B4775BC5B65291229B1EB"><enum>(d)</enum><header display-inline="yes-display-inline">Vacancies</header><text display-inline="yes-display-inline">Any member appointed to fill a vacancy
occurring before the expiration of the term for which the member’s predecessor
was appointed shall be appointed only for the remainder of that term. A member
may serve after the expiration of that member’s term until a successor has
taken office. Any vacancy in the membership of the Commission shall be filled
in the manner in which the original appointment was made and shall not affect
the power of the remaining members to execute the duties of the
Commission.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="H946AA09EBD43493EA75E859B07027910"><enum>(e)</enum><header display-inline="yes-display-inline">Compensation</header>
<paragraph commented="no" display-inline="no-display-inline" id="H10523B2CA39F4BD1B2E130643BC959F3"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Members of the Commission shall serve
without pay.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HC66FA45DC3314329893D08A8DD0078C5"><enum>(2)</enum><header display-inline="yes-display-inline">Travel expenses</header><text display-inline="yes-display-inline">All members of the Commission shall be
reimbursed for travel and per diem in lieu of subsistence expenses during the
performance of duties of the Commission while away from their homes or regular
places of business, in accordance with subchapter I of
<external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/57">chapter
57</external-xref> of title 5, United States Code.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HD3944A32F5554437872E288248BC2678"><enum>(f)</enum><header display-inline="yes-display-inline">Quorum</header><text display-inline="yes-display-inline">A quorum shall consist of 9 members of the
Commission, except that 6 or more members may conduct a hearing under section
105(a).</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="HDFB2E8B38C654BD8A482001F1810595B"><enum>(g)</enum><header display-inline="yes-display-inline">Meetings</header><text display-inline="yes-display-inline">The Commission shall meet at the call of
its chairperson or a majority of its members.</text>
</subsection></section><section commented="no" display-inline="no-display-inline" id="H7B46CC4A8E0943AE9BA2C7F5C5B4FEB6" section-type="subsequent-section"><enum>104.</enum><header display-inline="yes-display-inline">Staff and consultants</header>
<subsection commented="no" display-inline="no-display-inline" id="HC41DCAC6D10A4A9BA839015EF52F8B9F"><enum>(a)</enum><header display-inline="yes-display-inline">Staff</header><text display-inline="yes-display-inline">The Commission may appoint and determine
the compensation of such staff as may be necessary to carry out the duties of
the Commission. Such appointments and compensation may be made without regard
to the provisions of title 5, United States Code, that govern appointments in
the competitive services, and the provisions of chapter 51 and subchapter III
of chapter 53 of such title that relate to classifications and the General
Schedule pay rates.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="H4C3572F4FA4240A6B61E16F900B5A414"><enum>(b)</enum><header display-inline="yes-display-inline">Consultants</header><text display-inline="yes-display-inline">The Commission may procure such temporary
and intermittent services of experts and consultants as the Commission
determines to be necessary to carry out the duties of the Commission, in
accordance with <external-xref legal-doc="usc" parsable-cite="usc/5/3109">section 3109(b)</external-xref> of title 5, United
States Code, but at rates for individuals not to exceed the daily equivalent of
the maximum annual rate of basic pay payable for grade GS–15 of the General
Schedule under section 5332 of such title.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="H48AB2B91F40C4BC7933F83CF4D4780F9"><enum>(c)</enum><header display-inline="yes-display-inline">Detail of Federal employees</header><text display-inline="yes-display-inline">Upon the request of the Commission, the
head of any Federal agency is authorized to detail, without reimbursement to
the agency, any of the personnel of such agency to the Commission to assist the
Commission in carrying out its duties. Any such detail shall not interrupt or
otherwise affect the civil service status or privileges of such
personnel.</text>
</subsection></section><section commented="no" display-inline="no-display-inline" id="H2B6E70D45DAF4EAA83CF28DB0499B00" section-type="subsequent-section"><enum>105.</enum><header display-inline="yes-display-inline">Powers</header>
<subsection commented="no" display-inline="no-display-inline" id="H11EEE06E09D34C550004E014E831F6BC"><enum>(a)</enum><header display-inline="yes-display-inline">Hearings and other activities</header><text display-inline="yes-display-inline">The Commission may, for the purpose of
carrying out this title, hold hearings, sit and act at times and places, take
testimony, and receive evidence as the Commission determines necessary to carry
out its duties. The Commission may administer oaths or affirmations to
witnesses appearing before it.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="HC9025AF701364DD49D555FD92070FAC6"><enum>(b)</enum><header display-inline="yes-display-inline">Studies by government accountability
office</header><text display-inline="yes-display-inline">Upon the request of
the Commission, the Comptroller General shall conduct such studies or
investigations as the Commission determines to be necessary to carry out its
duties.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="H67031A6FD18E4780AF1892B985E54427"><enum>(c)</enum><header display-inline="yes-display-inline">Cost estimates by Congressional Budget
Office</header>
<paragraph commented="no" display-inline="no-display-inline" id="HC9CD9AD120144AE29D665F2F711B023E"><enum>(1)</enum><header display-inline="yes-display-inline">Duty to provide requested
estimates</header><text display-inline="yes-display-inline">Upon the request of
the Commission, the Director of the Congressional Budget Office shall provide
to the Commission such cost estimates as the Commission determines to be
necessary to carry out its duties.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H50A8D6CE8267431B99A74D391BFA9B1F"><enum>(2)</enum><header display-inline="yes-display-inline">Reimbursement for development of cost
estimates</header><text display-inline="yes-display-inline">The Commission
shall reimburse the Director of the Congressional Budget Office for expenses
relating to the employment in the office of the Director of such additional
staff as may be necessary for the Director to comply with requests by the
Commission under paragraph (1).</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H9A3AF0E92F0B49938C05352D744E12F9"><enum>(d)</enum><header display-inline="yes-display-inline">Technical assistance</header><text display-inline="yes-display-inline">Upon the request of the Commission, the
head of a Federal agency shall provide such technical assistance to the
Commission as the Commission determines to be necessary to carry out its
duties.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="H0C6FDBC98F1D4FA4B0B9C54400651B00"><enum>(e)</enum><header display-inline="yes-display-inline">Use of mails</header><text display-inline="yes-display-inline">The Commission may use the United States
mails in the same manner and under the same conditions as Federal agencies, and
shall, for purposes of the frank, be considered a commission of Congress as
described in <external-xref legal-doc="usc" parsable-cite="usc/39/3215">section
3215</external-xref> of title 39, United States Code.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="H9749B441AA934572A59CF48B95D90300"><enum>(f)</enum><header display-inline="yes-display-inline">Obtaining information</header><text display-inline="yes-display-inline">The Commission may secure directly from any
Federal agency information necessary to enable it to carry out its duties, if
the information may be disclosed under
<external-xref legal-doc="usc" parsable-cite="usc/5/552">section
552</external-xref> of title 5, United States Code. Upon request of the
Chairperson of the Commission, the head of such agency shall furnish such
information to the Commission.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="H73D3A063AD344023BDE098E18BF44F90"><enum>(g)</enum><header display-inline="yes-display-inline">Administrative support
services</header><text display-inline="yes-display-inline">Upon the request of
the Commission, the Administrator of General Services shall provide to the
Commission on a reimbursable basis such administrative support services as the
Commission may request.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="HF997B7E9B10A44FFB6604600C2004431"><enum>(h)</enum><header display-inline="yes-display-inline">Acceptance of donations</header><text display-inline="yes-display-inline">The Commission may accept, use, and dispose
of gifts and donations of services or property.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="HB08BF477F9B1484396DEF87BC14EFC6C"><enum>(i)</enum><header display-inline="yes-display-inline">Printing</header><text display-inline="yes-display-inline">For purposes of costs relating to printing
and binding, including the costs of personnel detailed from the Government
Printing Office, the Commission shall be deemed to be a committee of the
Congress.</text>
</subsection></section><section commented="no" display-inline="no-display-inline" id="H3E77B23CF67642F5B8648300A6D9BD43" section-type="subsequent-section"><enum>106.</enum><header display-inline="yes-display-inline">Report on ways to promote the effective
delivery of emergency medical services</header><text display-inline="no-display-inline">Not later than the date that is 18 months
after the date of the enactment of this Act, the Commission shall submit to
Congress and the Secretary of Health and Human Services a report containing its
findings and recommendations described in section 102(a), including
recommendations to remove any identified barriers to the effective delivery of
emergency medical services in the United States and detailed recommendations
for appropriate legislative initiatives to remove such barriers.</text>
</section><section commented="no" display-inline="no-display-inline" id="H5C7B6EC7463140C69B4FAE2217CFF207" section-type="subsequent-section"><enum>107.</enum><header display-inline="yes-display-inline">Termination</header><text display-inline="no-display-inline">The Commission shall terminate 30 days after
the date of submission of the report required in section 106.</text>
</section><section commented="no" display-inline="no-display-inline" id="H9C0F2A74CF95431DB5C440031451E86E" section-type="subsequent-section"><enum>108.</enum><header display-inline="yes-display-inline">Authorization of
appropriations</header><text display-inline="no-display-inline">There are
authorized to be appropriated such sums as may be necessary to carry out this
title.</text>
</section><enum>II</enum><header display-inline="yes-display-inline">Additional payments for certain physicians’
services</header>
<section commented="no" display-inline="no-display-inline" id="HB29A2C85AC0C4BCD84904E7551FF71D0" section-type="subsequent-section"><enum>201.</enum><header display-inline="yes-display-inline">Additional payments for certain physicians’
services</header>
<subsection commented="no" display-inline="no-display-inline" id="H0823FF52AA0B4BDA87E600CD17B992B4"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 1833 of the Social Security Act (42
U.S.C. 1395l) is amended by adding at the end the following new
subsection:</text>
<quoted-block display-inline="no-display-inline" id="HA05B24A5FBE74C2BB95C927B3E1F00CF" style="OLC">
<subsection commented="no" display-inline="no-display-inline" id="HAC389CDF306D49B39D247DD4CF529B8"><enum>(x)</enum><header display-inline="yes-display-inline">Additional payment for physicians’ services
furnished pursuant to EMTALA</header><text display-inline="yes-display-inline">In the case of physicians’ services
furnished in the emergency department of a hospital (as defined in subsection
(e)(5) of section 1867) pursuant to such section to an individual covered under
the insurance program established under this part, in addition to the amount of
payment that will otherwise be made for such services under this part, there
shall also be paid to the physician or other person involved (or in the cases
described in subparagraph (A) of section 1842(b)(6), to an employer or other
entity involved) from the Federal Supplementary Trust Fund an amount equal to
10 percent of the payment amount for the services under this part (determined
without regard to any additional amounts paid under subsection (m) or
(u)).</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" display-inline="no-display-inline" id="HE6D3709F563B477A85230400FF9FA0A5"><enum>(b)</enum><header display-inline="yes-display-inline">Effective
date</header><text display-inline="yes-display-inline">The amendment made by
subsection (a) shall apply to services furnished on or after the date of the
enactment of this Act.</text>
</subsection></section><enum>III</enum><header display-inline="yes-display-inline">Centers for Medicare & Medicaid
Services Working Group to improve emergency care efficiency</header>
<section commented="no" display-inline="no-display-inline" id="H85C36D08EE834E7AB0E50026D4EDB1D0" section-type="subsequent-section"><enum>301.</enum><header display-inline="yes-display-inline">Centers for Medicare & Medicaid
Services Working Group to improve emergency care efficiency</header>
<subsection commented="no" display-inline="no-display-inline" id="id599C169E0BF6402FA9F395448D1348FE"><enum>(a)</enum><header display-inline="yes-display-inline">Working group</header>
<paragraph commented="no" display-inline="no-display-inline" id="id38900E1DA2A64AE8A80F6AC707D320A4"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services,
acting through the Administrator of the Centers for Medicare & Medicaid
Services, shall convene a working group (in this section referred to as the
<quote>CMS working group</quote>) that includes experts in emergency care,
inpatient critical care, hospital operations management, nursing, and other
relevant disciplines. The members of the CMS working group shall be appointed
by the Administrator.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id6DA1EF0E16B046989C74932E2200C131"><enum>(2)</enum><header display-inline="yes-display-inline">Duties</header>
<subparagraph commented="no" display-inline="no-display-inline" id="idB753377023034BAA929CA29746BA42FB"><enum>(A)</enum><header display-inline="yes-display-inline">Development of standards, guidelines,
measures, and incentives</header><text display-inline="yes-display-inline">The
CMS working group shall develop boarding and diversion standards, guidelines,
measures, and incentives for hospitals, and, with respect to the development of
measures, the CMS working group shall consider measures developed or under
development by other entities. The CMS working group shall send any measures
developed under this subparagraph to the entity with a contract under section
1890(a) of the Social Security Act (42 U.S.C. 1395aaa(a)) for consideration,
and shall take into account whether such measures have been recommended or
adopted for use by a relevant quality alliance identified by the Secretary
(such as the Hospital Quality Alliance).</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="IDbdb53aecac134c9e92fc54d32e017085"><enum>(B)</enum><header display-inline="yes-display-inline">Identification of barriers</header><text display-inline="yes-display-inline">The CMS working group shall identify
barriers contributing to delays in timely processing of patients requiring
admission as an inpatient of a hospital who initially sought care through the
emergency department of the hospital.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ID86f7f5bc99284884bfd05aa8d4f0acc6"><enum>(C)</enum><header display-inline="yes-display-inline">Identification of best
practices</header><text display-inline="yes-display-inline">The CMS working
group shall identify best practices to improve patient flow within hospitals.
In order to carry out the preceding sentence, the Agency for Healthcare
Research and Quality shall examine available evidence of best practices to
improve patient flow within hospitals and transmit any findings from that
examination to the CMS working group. The CMS working group shall take into
account the findings of the Agency in identifying such best practices under
this subparagraph.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id67E1A54507704DF3936B643B9B93FE84"><enum>(D)</enum><header display-inline="yes-display-inline">Report</header><text display-inline="yes-display-inline">Not later than the date that is 1 year
after the date of the enactment of this Act, the CMS Working Group shall submit
to Congress and the Secretary of Health and Human Services a report containing
a detailed description of the standards, guidelines, measures, and incentives
developed under subparagraph (A), the barriers identified under subparagraph
(B), and the best practices identified under subparagraph (C), together with
recommendations for such legislative and administrative actions as the CMS
Working group considers appropriate.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id0FBC9EA86C974A8EA890DC80CA2C1171"><enum>(3)</enum><header display-inline="yes-display-inline">Information</header><text display-inline="yes-display-inline">In carrying out its duties under paragraph
(2), the CMS Working Group may request such information from hospitals that the
CMS Working Group considers appropriate.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id58B191B66CB94C32B8C7D68D5BC5185C"><enum>(4)</enum><header display-inline="yes-display-inline">Termination</header><text display-inline="yes-display-inline">The CMS Working Group shall terminate 30
days after the date of submission of the report required in paragraph
(2)(D).</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="ID2e2ce6dade5a4683b98750a05791b44b"><enum>(b)</enum><header display-inline="yes-display-inline">Disclosure of failure To
report</header><text display-inline="yes-display-inline">The Secretary of
Health and Human Services shall establish a mechanism (such as publication on
an Internet website or in the Federal Register, or both) to disclose to the
public information regarding any hospital that fails to report information
requested by the CMS working group under subsection (a)(3) and the type of
information the hospital failed to report.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="id15FD369CD43C47CEBD5420404829E1CA"><enum>(c)</enum><header display-inline="yes-display-inline">Hospital defined</header><text display-inline="yes-display-inline">In this section, the term
<term>hospital</term> means a hospital (as defined in subsection (e) of section
1861 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x</external-xref>)) and a critical
access hospital (as defined in subsection (mm) of such section).</text>
</subsection></section>