To amend the Public Health Service Act to protect certain health care providers against legal liability for providing emergency and related care to uninsured individuals.

Summary: Ensuring Access to Emergency Rooms Act of 2004 - Amends the Public Health Service Act to deem hospitals, emergency rooms, physicians, and physicians groups that provide emergency care to uninsured individuals employees of the Public Health Service for purposes of any civil action that may arise due to items and services furnished and post-stabilization services provided to such individuals.

Requires the Attorney General to make separate estimates as to the cost of claims expected to arise under this Act and to establish separate funds for such claims. Requires the Secretary of Health and Human Services to limit the total amount of payments under this Act to the amounts appropriated in advance for such purposes.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ensuring Access to Emergency Rooms 
Act of 2004''.

SEC. 2. CONSTITUTIONAL AUTHORITY.

    The constitutional authority upon which this Act rests is the power 
of the Congress to provide for the general welfare, to regulate 
commerce, and to make all laws which shall be necessary and proper for 
carrying into execution Federal powers, as enumerated in section 8 of 
article I of the Constitution of the United States.

SEC. 3. PROTECTION AGAINST LEGAL LIABILITY FOR EMERGENCY AND RELATED 
              SERVICES FURNISHED TO UNINSURED INDIVIDUALS.

    Section 224(g) of the Public Health Service Act (42 U.S.C. 233(g)) 
is amended--
            (1) in paragraph (4), by striking ``An entity'' and 
        inserting in lieu thereof ``Subject to paragraph (6), an 
        entity''; and
            (2) by adding at the end the following:
            ``(6)(A) For purposes of this section--
                    ``(i) an entity described in subparagraph (B) shall 
                be considered to be an entity described in paragraph 
                (4); and
                    ``(ii) the provisions of this section shall apply 
                to an entity described in subparagraph (B) in the same 
                manner as such provisions apply to an entity described 
                in paragraph (4), except that--
                            ``(I) notwithstanding paragraph (1)(B), the 
                        deeming of any entity described in subparagraph 
                        (B), or of an officer, governing board member, 
                        employee, or contractor of such an entity, to 
                        be an employee of the Public Health Service for 
                        purposes of this section shall apply only with 
                        respect to items and services that are 
                        furnished to an uninsured individual (as 
                        defined in subparagraph (C)) pursuant to 
                        section 1867 of the Social Security Act and to 
                        post-stabilization services (as defined in 
                        subparagraph (D)) furnished to such an 
                        individual;
                            ``(II) nothing in paragraph (1)(D) shall be 
                        construed as preventing a physician or 
                        physician group described in subparagraph 
                        (B)(ii) from making the application referred to 
                        in such paragraph or as conditioning the 
                        deeming of a physician or physician group that 
                        makes such an application upon receipt by the 
                        Secretary of an application from the hospital 
                        or emergency department that employs or 
                        contracts with the physician or group;
                            ``(III) notwithstanding paragraph (3), this 
                        paragraph shall apply only with respect to 
                        causes of action arising from acts or omissions 
                        that occur on or after January 1, 2003;
                            ``(IV) paragraph (5) shall not apply to a 
                        physician or physician group described in 
                        subparagraph (B)(ii);
                            ``(V) the Attorney General, in consultation 
                        with the Secretary, shall make separate 
                        estimates under subsection (k)(1) with respect 
                        to entities described in subparagraph (B) and 
                        entities described in paragraph (4) (other than 
                        those described in subparagraph (B)), and the 
                        Secretary shall establish separate funds under 
                        subsection (k)(2) with respect to such groups 
                        of entities, and any appropriations under this 
                        subsection for entities described in 
                        subparagraph (B) shall be separate from the 
                        amounts authorized by subsection (k)(2);
                            ``(VI) notwithstanding subsection (k)(2), 
                        the amount of the fund established by the 
                        Secretary under such subsection with respect to 
                        entities described in subparagraph (B) may 
                        exceed a total of $10,000,000 for a fiscal 
                        year; and
                            ``(VII) subsection (m) shall not apply to 
                        entities described in subparagraph (B).
            ``(B) An entity described in this subparagraph is--
                    ``(i) a hospital or an emergency department to 
                which section 1867 of the Social Security Act applies; 
                and
                    ``(ii) a physician or physician group that is 
                employed by, or under contract with, such hospital or 
                department to furnish items and services to individuals 
                under such section.
            ``(C) For purposes of this paragraph, the term `uninsured 
        individual' means an individual who, at the time treatment is 
        provided by an entity described in subparagraph (B) for 
        purposes of complying with section 1867 of the Social Security 
        Act--
                    ``(i) does not have coverage under--
                            ``(I) a group health plan (as defined in 
                        section 2791(a)(1));
                            ``(II) part A or B of title XVIII of the 
                        Social Security Act; or
                            ``(III) a State plan under title XIX of 
                        such Act; and
                    ``(ii) does not have health insurance coverage (as 
                defined in section 2791(b)(1) of the Public Health 
                Service Act (42 U.S.C. 300gg-91(b)(1)) from any other 
                source.
            ``(D) For purposes of this paragraph, the term `post-
        stabilization services' means, with respect to an individual 
        who has been treated by an entity described in subparagraph (B) 
        for purposes of complying with section 1867 of the Social 
        Security Act, services that are--
                    ``(i) related to the condition that was so treated; 
                and
                    ``(ii) provided after the individual is stabilized 
                in order to maintain the stabilized condition or to 
                improve or resolve the individual's condition.
            ``(E)(i) Nothing in this paragraph (or in any other 
        provision of this section as such provision applies to entities 
        described in subparagraph (B) by operation of subparagraph (A)) 
        shall be construed as authorizing or requiring the Secretary to 
        make payments to such entities, the budget authority for which 
        is not provided in advance by appropriation Acts.
            ``(ii) The Secretary shall limit the total amount of 
        payments under this paragraph for a fiscal year to the total 
        amount appropriated in advance by appropriation Acts for such 
        purpose for such fiscal year. If the total amount of payments 
        that would otherwise be made under this paragraph for a fiscal 
        year exceeds such total amount appropriated, the Secretary 
        shall take such steps as may be necessary to ensure that the 
        total amount of payments under this paragraph for such fiscal 
        year does not exceed such total amount appropriated.''.