G:\M\16\RUSH\RUSH_065.XML ..................................................................... (Original Signature of Member) 116TH CONGRESS 2D SESSION H. R. ll To provide for a study by the National Academy of Medicine on ambulance diversions, and for other purposes. IN THE HOUSE OF REPRESENTATIVES Mr. RUSH introduced the following bill; which was referred to the Committee on llllllllllllll A BILL To provide for a study by the National Academy of Medicine on ambulance diversions, and for other purposes. 1 Be it enacted by the Senate and House of Representa- 2 tives of the United States of America in Congress assembled, 3 SECTION 1. SHORT TITLE. 4 This Act may be cited as the ‘‘Research Empirical 5 Solutions to End Ambulance Reversals from Closed Hos6 pitals Act of 2020’’ or the ‘‘RESEARCH Act of 2020’’. 7 SEC. 2. STUDY ON AMBULANCE DIVERSIONS. 8 (a) STUDY.—The Secretary of Health and Human 9 Services shall seek to enter into an agreement with the g:\VHLC\012820\012820.057.xml January 28, 2020 (10:34 a.m.) VerDate Mar 15 2010 10:34 Jan 28, 2020 Jkt 000000 (749890 19) PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 C:\USERS\WPBURKE\APPDATA\ROAMING\SOFTQUAD\XMETAL\7.0\GEN\C\RUSH_065.X G:\M\16\RUSH\RUSH_065.XML 2 1 National Academy of Medicine under which the National 2 Academy agrees to conduct a study on ambulance diver3 sions, including— 4 (1) whether the number of such diversions have 5 increased over the last 10 years, including whether 6 the number of such diversions have increased at the 7 national, regional, State, and local level; 8 9 (2) what steps, if any, have been taken to reduce the number of such diversions; 10 (3) whether such diversions disproportionately 11 impact medically underserved communities (as de- 12 fined in section 799B of the Public Health Service 13 Act (42 U.S.C. 295p)); and 14 15 (4) what actions the Federal Government should take— 16 (A) to reduce the number of ambulance di- 17 versions; and 18 (B) to improve the health and safety of pa- 19 20 tients affected by ambulance diversions. (b) CONSULTATION.—The agreement under sub- 21 section (a) shall require the study under such agreement 22 to be conducted in consultation with— 23 (1) the Assistant Secretary for Planning and 24 Evaluation of the Department of Health and Human 25 Services; g:\VHLC\012820\012820.057.xml January 28, 2020 (10:34 a.m.) VerDate Mar 15 2010 10:34 Jan 28, 2020 Jkt 000000 (749890 19) PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 C:\USERS\WPBURKE\APPDATA\ROAMING\SOFTQUAD\XMETAL\7.0\GEN\C\RUSH_065.X G:\M\16\RUSH\RUSH_065.XML 3 1 (2) the Assistant Secretary for Preparedness 2 and Response of the Department of Health and 3 Human Services; and 4 (3) the Director of the Office of Emergency 5 Care Research of the National Institutes of Health. 6 (c) REPORT.—The agreement under subsection (a) 7 shall provide for— 8 (1) the submission to the congressional commit- 9 tees of jurisdiction, not later than 24 months after 10 the date of enactment of this Act, of a report on the 11 results of the study under such agreement; and 12 (2) the inclusion in such report of recommenda- 13 tions on actions the Federal Government should 14 take— 15 (A) to mitigate the occurrence of ambu- 16 lance diversions; and 17 (B) to improve the health and safety of pa- 18 tients affected by ambulance diversions. 19 (d) DEFINITION.—In this section, the term ‘‘ambu- 20 lance diversion’’ means the temporary closure of a hospital 21 emergency department to incoming ambulances. 22 SEC. 3. HOSPITAL REPORTING REQUIREMENT. 23 (a) REPORTING REQUIREMENT.—A hospital shall re- 24 port to the Secretary of Health and Human Services, in g:\VHLC\012820\012820.057.xml January 28, 2020 (10:34 a.m.) VerDate Mar 15 2010 10:34 Jan 28, 2020 Jkt 000000 (749890 19) PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 C:\USERS\WPBURKE\APPDATA\ROAMING\SOFTQUAD\XMETAL\7.0\GEN\C\RUSH_065.X G:\M\16\RUSH\RUSH_065.XML 4 1 the case the hospital implements an ambulance diversion 2 on or after January 1, 2021— 3 (1) how long the diversion was in effect; 4 (2) the reason for the diversion; and 5 (3) the number of ambulance calls the hospital 6 diverted while the diversion was in effect. 7 (b) ENFORCEMENT.— 8 (1) HOSPITALS.—Section 1886(d)(5) of the So- 9 cial Security Act (42 U.S.C. 1395ww(d)(5)) is 10 amended by adding at the end the following new 11 subparagraph: 12 ‘‘(M)(i)(I) In the case that the Secretary determines, 13 with respect to a calendar quarter occurring in the period 14 beginning with 2021 and ending with 2024, that a hospital 15 has complied with the provisions of section 3(a) of the RE16 SEARCH Act of 2020 with respect to each ambulance di17 version (if any) that occurred during such quarter, the 18 Secretary shall increase, by the percentage specified in 19 subclause (II) for such quarter, the amount otherwise pay20 able to such hospital under paragraph (1)(A) for dis21 charges occurring in the succeeding quarter. 22 ‘‘(II) For purposes of subclause (I), the percentage 23 specified in this subclause is, with respect a calendar quar24 ter occurring in— 25 ‘‘(aa) 2021 or 2022, 1 percent; or g:\VHLC\012820\012820.057.xml January 28, 2020 (10:34 a.m.) VerDate Mar 15 2010 10:34 Jan 28, 2020 Jkt 000000 (749890 19) PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 C:\USERS\WPBURKE\APPDATA\ROAMING\SOFTQUAD\XMETAL\7.0\GEN\C\RUSH_065.X G:\M\16\RUSH\RUSH_065.XML 5 1 2 ‘‘(bb) 2023 or 2024, 0.5 percent. ‘‘(ii)(I) In the case that the Secretary determines, 3 with respect to a calendar quarter occurring in 2025 or 4 a subsequent year, that a hospital has failed to report an 5 ambulance diversion occurring during such quarter to the 6 Secretary in accordance with section 3(a) of the RE7 SEARCH Act of 2020, the Secretary shall reduce, by the 8 percentage specified in subclause (II) for such quarter, the 9 amount otherwise payable to such hospital under para10 graph (1)(A) for discharges occurring in the succeeding 11 quarter. 12 ‘‘(II) For purposes of subclause (I), the percentage 13 specified in this subclause is, with respect a calendar quar14 ter occurring in— 15 ‘‘(aa) 2025, 1 percent; or 16 ‘‘(bb) 2026 or a subsequent year, 2 percent. 17 ‘‘(iii) In this subparagraph, the term ‘ambulance di- 18 version’ has the meaning given such term in section 2 of 19 the RESEARCH Act of 2020.’’. 20 (2) CRITICAL ACCESS HOSPITALS.—Section 21 1814(l) of the Social Security Act (42 U.S.C. 22 1395f(l)) is amended by adding at the end the fol- 23 lowing new paragraph: 24 ‘‘(6)(A)(i) In the case that the Secretary determines, 25 with respect to a calendar quarter occurring in the period g:\VHLC\012820\012820.057.xml January 28, 2020 (10:34 a.m.) VerDate Mar 15 2010 10:34 Jan 28, 2020 Jkt 000000 (749890 19) PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 C:\USERS\WPBURKE\APPDATA\ROAMING\SOFTQUAD\XMETAL\7.0\GEN\C\RUSH_065.X G:\M\16\RUSH\RUSH_065.XML 6 1 beginning with 2021 and ending with 2024, that a critical 2 access hospital has complied with the provisions of section 3 3(a) of the RESEARCH Act of 2020 with respect to each 4 ambulance diversion (if any) that occurred during such 5 quarter, the Secretary shall increase, by the percentage 6 specified in clause (ii) for such quarter, the amount other7 wise payable to such hospital under paragraph (1) for 8 services furnished during the succeeding quarter. 9 ‘‘(ii) For purposes of clause (i), the percentage speci- 10 fied in this clause is, with respect a calendar quarter oc11 curring in— 12 ‘‘(I) 2021 or 2022, 1 percent; or 13 ‘‘(II) 2023 or 2024, 0.5 percent. 14 ‘‘(B)(i) In the case that the Secretary determines, 15 with respect to a calendar quarter occurring in 2025 or 16 a subsequent year, that a critical access hospital has failed 17 to report an ambulance diversion occurring during such 18 quarter to the Secretary in accordance with section 3(a) 19 of the RESEARCH Act of 2020, the Secretary shall re20 duce, by the percentage specified in clause (ii) for such 21 quarter, the amount otherwise payable to such hospital 22 under paragraph (1) for services furnished during the suc23 ceeding quarter. g:\VHLC\012820\012820.057.xml January 28, 2020 (10:34 a.m.) VerDate Mar 15 2010 10:34 Jan 28, 2020 Jkt 000000 (749890 19) PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 C:\USERS\WPBURKE\APPDATA\ROAMING\SOFTQUAD\XMETAL\7.0\GEN\C\RUSH_065.X G:\M\16\RUSH\RUSH_065.XML 7 1 ‘‘(ii) For purposes of clause (i), the percentage speci- 2 fied in this clause is, with respect a calendar quarter oc3 curring in— 4 ‘‘(I) 2025, 1 percent; or 5 ‘‘(II) 2026 or a subsequent year, 2 percent.’’. 6 (c) DEFINITION.—In this section: 7 8 (1) The term ‘‘ambulance diversion’’ has the meaning given to such term in section 2. 9 (2) The term ‘‘hospital’’ means a subsection (d) 10 hospital (as defined in section 1886(d)(1)(B) of the 11 Social Security Act (42 U.S.C. 1395ww(d)(1)(B))), 12 or a critical access hospital (as defined in section 13 1861(mm) of such Act (42 U.S.C. 1395x(mm))), en- 14 rolled under section 1866(j) of such Act (42 U.S.C. 15 1392cc(j)). g:\VHLC\012820\012820.057.xml January 28, 2020 (10:34 a.m.) VerDate Mar 15 2010 10:34 Jan 28, 2020 Jkt 000000 (749890 19) PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 C:\USERS\WPBURKE\APPDATA\ROAMING\SOFTQUAD\XMETAL\7.0\GEN\C\RUSH_065.X