I 

116TH CONGRESS 

2D SESSION H. R. 5727 

To provide for a study by the National Academy of Medicine on ambulance 

diversions, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 30, 2020 

Mr. RUSH (for himself, Mr. THOMPSON of Mississippi, Mrs. WATSON COLEMAN, and Ms. BARRAGA ́N) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the 

Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions 

as fall within the jurisdiction of the committee concerned 

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 Representa2 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’’. 


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1 SEC. 2. STUDY ON AMBULANCE DIVERSIONS. 

2 (a) STUDY.—The Secretary of Health and Human 

3 Services shall seek to enter into an agreement with the 

4 National Academy of Medicine under which the National 

5 Academy agrees to conduct a study on ambulance diver6 sions, including— 

7 (1) whether the number of such diversions have 

8 increased over the last 10 years, including whether 

9 the number of such diversions have increased at the 

10 national, regional, State, and local level; 

11 (2) what steps, if any, have been taken to re12 duce the number of such diversions; 

13 (3) whether such diversions disproportionately 

14 impact medically underserved communities (as de15 fined in section 799B of the Public Health Service 

16 Act (42 U.S.C. 295p)); and 

17 (4) what actions the Federal Government 

18 should take— 

19 (A) to reduce the number of ambulance di20 versions; and 

21 (B) to improve the health and safety of pa22 tients affected by ambulance diversions. 

23 (b) CONSULTATION.—The agreement under sub24 section (a) shall require the study under such agreement 

25 to be conducted in consultation with— 


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1 (1) the Assistant Secretary for Planning and 

2 Evaluation of the Department of Health and Human 

3 Services; 

4 (2) the Assistant Secretary for Preparedness 

5 and Response of the Department of Health and 

6 Human Services; and 

7 (3) the Director of the Office of Emergency 

8 Care Research of the National Institutes of Health. 

9 (c) REPORT.—The agreement under subsection (a) 

10 shall provide for— 

11 (1) the submission to the congressional commit12 tees of jurisdiction, not later than 24 months after 

13 the date of enactment of this Act, of a report on the 

14 results of the study under such agreement; and 

15 (2) the inclusion in such report of recommenda16 tions on actions the Federal Government should 

17 take— 

18 (A) to mitigate the occurrence of ambu19 lance diversions; and 

20 (B) to improve the health and safety of pa21 tients affected by ambulance diversions. 

22 (d) DEFINITION.—In this section, the term ‘‘ambu23 lance diversion’’ means the temporary closure of a hospital 

24 emergency department to incoming ambulances. 


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1 SEC. 3. HOSPITAL REPORTING REQUIREMENT. 

2 (a) REPORTING REQUIREMENT.—A hospital shall re3 port to the Secretary of Health and Human Services, in 

4 the case the hospital implements an ambulance diversion 

5 on or after January 1, 2021— 

6 (1) how long the diversion was in effect; 

7 (2) the reason for the diversion; and 

8 (3) the number of ambulance calls the hospital 

9 diverted while the diversion was in effect. 

10 (b) ENFORCEMENT.— 

11 (1) HOSPITALS.—Section 1886(d)(5) of the So12 cial Security Act (42 U.S.C. 1395ww(d)(5)) is 

13 amended by adding at the end the following new 

14 subparagraph: 

15 ‘‘(M)(i)(I) In the case that the Secretary determines, 

16 with respect to a calendar quarter occurring in the period 

17 beginning with 2021 and ending with 2024, that a hospital 

18 has complied with the provisions of section 3(a) of the RE19 SEARCH Act of 2020 with respect to each ambulance di20 version (if any) that occurred during such quarter, the 

21 Secretary shall increase, by the percentage specified in 

22 subclause (II) for such quarter, the amount otherwise pay23 able to such hospital under paragraph (1)(A) for dis24 charges occurring in the succeeding quarter. 


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1 ‘‘(II) For purposes of subclause (I), the percentage 

2 specified in this subclause is, with respect to a calendar 

3 quarter occurring in— 

4 ‘‘(aa) 2021 or 2022, 1 percent; or 

5 ‘‘(bb) 2023 or 2024, 0.5 percent. 

6 ‘‘(ii)(I) In the case that the Secretary determines, 

7 with respect to a calendar quarter occurring in 2025 or 

8 a subsequent year, that a hospital has failed to report an 

9 ambulance diversion occurring during such quarter to the 

10 Secretary in accordance with section 3(a) of the RE11 SEARCH Act of 2020, the Secretary shall reduce, by the 

12 percentage specified in subclause (II) for such quarter, the 

13 amount otherwise payable to such hospital under para14 graph (1)(A) for discharges occurring in the succeeding 

15 quarter. 

16 ‘‘(II) For purposes of subclause (I), the percentage 

17 specified in this subclause is, with respect to a calendar 

18 quarter occurring in— 

19 ‘‘(aa) 2025, 1 percent; or 

20 ‘‘(bb) 2026 or a subsequent year, 2 percent. 

21 ‘‘(iii) In this subparagraph, the term ‘ambulance di22 version’ has the meaning given such term in section 2 of 

23 the RESEARCH Act of 2020.’’. 

24 (2) CRITICAL ACCESS HOSPITALS.—Section 

25 1814(l) of the Social Security Act (42 U.S.C. 


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1 1395f(l)) is amended by adding at the end the fol2 lowing new paragraph: 

3 ‘‘(6)(A)(i) In the case that the Secretary determines, 

4 with respect to a calendar quarter occurring in the period 

5 beginning with 2021 and ending with 2024, that a critical 

6 access hospital has complied with the provisions of section 

7 3(a) of the RESEARCH Act of 2020 with respect to each 

8 ambulance diversion (if any) that occurred during such 

9 quarter, the Secretary shall increase, by the percentage 

10 specified in clause (ii) for such quarter, the amount other11 wise payable to such hospital under paragraph (1) for 

12 services furnished during the succeeding quarter. 

13 ‘‘(ii) For purposes of clause (i), the percentage speci14 fied in this clause is, with respect to a calendar quarter 

15 occurring in— 

16 ‘‘(I) 2021 or 2022, 1 percent; or 

17 ‘‘(II) 2023 or 2024, 0.5 percent. 

18 ‘‘(B)(i) In the case that the Secretary determines, 

19 with respect to a calendar quarter occurring in 2025 or 

20 a subsequent year, that a critical access hospital has failed 

21 to report an ambulance diversion occurring during such 

22 quarter to the Secretary in accordance with section 3(a) 

23 of the RESEARCH Act of 2020, the Secretary shall re24 duce, by the percentage specified in clause (ii) for such 

25 quarter, the amount otherwise payable to such hospital 


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1 under paragraph (1) for services furnished during the suc2 ceeding quarter. 

3 ‘‘(ii) For purposes of clause (i), the percentage speci4 fied in this clause is, with respect to a calendar quarter 

5 occurring in— 

6 ‘‘(I) 2025, 1 percent; or 

7 ‘‘(II) 2026 or a subsequent year, 2 percent.’’. 

8 (c) DEFINITION.—In this section: 

9 (1) The term ‘‘ambulance diversion’’ has the 

10 meaning given to such term in section 2. 

11 (2) The term ‘‘hospital’’ means a subsection (d) 

12 hospital (as defined in section 1886(d)(1)(B) of the 

13 Social Security Act (42 U.S.C. 1395ww(d)(1)(B))), 

14 or a critical access hospital (as defined in section 

15 1861(mm) of such Act (42 U.S.C. 1395x(mm))), en16 rolled under section 1866(j) of such Act (42 U.S.C. 

17 1392cc(j)). 

Æ 


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