[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 328 Introduced in Senate (IS)]

113th CONGRESS
  1st Session
                                 S. 328

   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.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 14, 2013

   Mr. Thune (for himself, Mr. Udall of New Mexico, and Mr. Bennet) 
introduced the following bill; which was read twice and referred to the 
                          Committee on Finance

_______________________________________________________________________

                                 A BILL


 
   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.

    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 ``Strengthening Rural Access to 
Emergency Services Act''.

SEC. 2. 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.

    (a) In General.--Section 1866(a) of the Social Security Act (42 
U.S.C. 1395cc(a)) is amended--
            (1) in paragraph (1)(I)(iii), by inserting ``(subject to 
        paragraph (4))'' after ``on call for duty''; and
            (2) by adding at the end the following new paragraph:
    ``(4)(A) 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--
            ``(i) in person; or
            ``(ii) subject to subparagraph (B), by interactive 
        telecommunications system (as defined in section 410.78(a)(3) 
        of title 42, Code of Federal Regulations).
    ``(B) Subparagraph (A)(ii) shall only apply if--
            ``(i) the physician available by such interactive 
        telecommunications system is board certified in emergency 
        medicine or pediatric emergency medicine; and
            ``(ii) a nurse practitioner or physician assistant (as 
        those terms are defined in section 1861(aa)(5)) is onsite in 
        the emergency department.
    ``(C) In this paragraph:
            ``(i) The term `applicable critical access hospital' means 
        a critical access hospital (as defined in section 1861(mm)(1)) 
        located--
                    ``(I) 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
                    ``(II) in a county that is not included in a 
                Metropolitan Statistical area.
            ``(ii) The term `applicable sole community hospital' means 
        a sole community hospital (as defined in section 
        1886(d)(5)(D)(iii)) that--
                    ``(I) has less than 50 beds;
                    ``(II) has an emergency department; and
                    ``(III) is located--
                            ``(aa) 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
                            ``(bb) in a county that is not included in 
                        a Metropolitan Statistical Area.''.
    (b) Conforming Amendments.--Section 1867 of the Social Security Act 
(42 U.S.C. 1395dd) is amended--
            (1) in subsection (b)(1)(A), by inserting ``(determined in 
        accordance with section 1866(a)(4))'' after ``hospital''; and
            (2) in subsection (d)(1)(C), in the first sentence, by 
        inserting ``(determined in accordance with section 
        1866(a)(4))'' after ``refuses to appear''.
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