H.R. 3134: Emergency Care Improvement Act

The proposed Emergency Care Improvement Act aims to enhance the coverage of certain services provided by freestanding emergency centers (FECs) under Medicare and Medicaid. Below are the main components of the bill:

1. Coverage Under Medicare and Medicaid

The bill seeks to amend the Social Security Act so that specified emergency services provided by FECs will be covered under Medicare Part B and Medicaid. This coverage would include emergency services that meet defined criteria and are not otherwise excluded by existing regulations.

2. Definitions of Freestanding Emergency Centers

It provides a definition for a freestanding emergency center, which is characterized as follows:

• Operational Hours: Open 24/7 with qualified medical staff on-site.
• Facility Standards: FECs must meet state requirements and provide emergency medical services without typically offering overnight stays.
• Location: Should be situated in metropolitan areas or specific rural areas that lack other emergency services.

3. Financial Considerations

The bill establishes payment frameworks for emergency services provided by FECs, ensuring that these centers will receive payments from Medicare similar to those received by traditional hospitals for similar services.

4. Amendment to Emergency Medical Treatment and Labor Act (EMTALA)

This bill clarifies that the regulations governing emergency medical treatment will also apply to freestanding emergency centers, ensuring they are held to the same standards as hospital emergency departments.

5. Exclusions from Self-Referral Prohibitions

It includes provisions that allow laboratory and imaging services provided by FECs in connection with specified emergency services to be excluded from the self-referral prohibition, which typically restricts physicians from referring patients to facilities in which they have a financial interest.

6. Effective Date

The changes proposed by this Act would take effect for services rendered starting from the date of enactment.

Relevant Companies

• HCA Healthcare (HCA) - As a major provider of healthcare services with various emergency facilities, this legislation may affect their operational and reimbursement processes pertaining to freestanding emergency centers.
• Tenet Healthcare (THC) - Their involvement with emergency services could be influenced by the expanded coverage and reimbursement rates for freestanding emergency centers under Medicare and Medicaid.