I 

108TH CONGRESS 

1ST SESSION H. R. 1382

To amend title XVIII of the Social Security Act to improve the regulatory 

operation of the Emergency Medical Treatment and Labor Act (EMTALA). 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 20, 2003

Mr. SHADEGG introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on 

Ways and Means, 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 amend title XVIII of the Social Security Act to improve 

the regulatory operation of the Emergency Medical 

Treatment and Labor Act (EMTALA).

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 ‘‘EMTALA Regulatory 

5 Improvement Act of 2003’’. 

6 SEC. 2. EMTALA IMPROVEMENTS. 

7 (a) NOTIFICATION OF PROVIDERS WHEN EMTALA 

8 INVESTIGATION CLOSED.—Section 1867(d) of the Social 
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1 Security Act (42 U.S.C. 42 U.S.C. 1395dd(d)) is amended 

2 by adding at the end the following new paragraph: 

3 ‘‘(4) NOTICE UPON CLOSING AN INVESTIGA4 TION.—The Secretary shall establish a procedure to 

5 notify hospitals and physicians when an investigation 

6 under this section is closed.’’. 

7 (b) PRIOR REVIEW BY PEER REVIEW ORGANIZA8 TIONS IN EMTALA CASES INVOLVING TERMINATION OF

9 PARTICIPATION.—

10 (1) IN GENERAL.—Section 1867(d)(3) of such 

11 Act (42 U.S.C. 1395dd(d)(3)) is amended—

12 (A) in the first sentence, by inserting ‘‘or 

13 in terminating a hospital’s participation under 

14 this title’’ after ‘‘in imposing sanctions under 

15 paragraph (1)’’; and 

16 (B) by adding at the end the following new 

17 sentences: ‘‘Except in the case in which a delay 

18 would jeopardize the health or safety of individ19 uals, the Secretary shall also request such a re20 view before making a compliance determination 

21 as part of the process of terminating a hos22 pital’s participation under this title for viola23 tions related to the appropriateness of a med24 ical screening examination, stabilizing treat25 ment, or an appropriate transfer as required by 
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1 this section, and shall provide a period of 5 

2 days for such review. The Secretary shall pro3 vide a copy of the organization’s report to the 

4 hospital or physician consistent with confiden5 tiality requirements imposed on the organiza6 tion under such part B.’’. 

7 (2) EFFECTIVE DATE.—The amendments made 

8 by paragraph (1) shall apply to terminations of par9 ticipation initiated on or after the date of the enact10 ment of this Act. 

11 SEC. 3. EMERGENCY MEDICAL TREATMENT AND ACTIVE 

12 LABOR ACT (EMTALA) TECHNICAL ADVISORY 

13 GROUP. 

14 (a) ESTABLISHMENT.—The Secretary shall establish 

15 a Technical Advisory Group (in this section referred to 

16 as the ‘‘Advisory Group’’) to review issues related to the 

17 Emergency Medical Treatment and Labor Act 

18 (EMTALA) and its implementation. In this section, the 

19 term ‘‘EMTALA’’ refers to the provisions of section 1867 

20 of the Social Security Act (42 U.S.C. 1395dd). 

21 (b) MEMBERSHIP.—The Advisory Group shall be 

22 composed of 19 members, including the Administrator of 

23 the Centers for Medicare & Medicaid Services and the In24 spector General of the Department of Health and Human 

25 Services and of which—
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1 (1) 4 shall be representatives of hospitals, in2 cluding at least one public hospital, that have experi3 ence with the application of EMTALA and at least 

4 2 of which have not been cited for EMTALA viola5 tions; 

6 (2) 7 shall be practicing physicians drawn from 

7 the fields of emergency medicine, cardiology or 

8 cardiothoracic surgery, orthopedic surgery, neuro9 surgery, pediatrics or a pediatric subspecialty, ob10 stetrics-gynecology, and psychiatry, with not more 

11 than one physician from any particular field; 

12 (3) 2 shall represent patients; 

13 (4) 2 shall be staff involved in EMTALA inves14 tigations from different regional offices of the Cen15 ters for Medicare & Medicaid Services; and 

16 (5) 1 shall be from a State survey office in17 volved in EMTALA investigations and 1 shall be 

18 from a peer review organization, both of whom shall 

19 be from areas other than the regions represented 

20 under paragraph (4). 

21 In selecting members described in paragraphs (1) through 

22 (3), the Secretary shall consider qualified individuals nom23 inated by organizations representing providers and pa24 tients. 
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1 (c) GENERAL RESPONSIBILITIES.—The Advisory 

2 Group—

3 (1) shall review EMTALA regulations; 

4 (2) may provide advice and recommendations to 

5 the Secretary with respect to those regulations and 

6 their application to hospitals and physicians; 

7 (3) shall solicit comments and recommendations 

8 from hospitals, physicians, and the public regarding 

9 the implementation of such regulations; and 

10 (4) may disseminate information on the applica11 tion of such regulations to hospitals, physicians, and 

12 the public. 

13 (d) ADMINISTRATIVE MATTERS.—

14 (1) CHAIRPERSON.—The members of the Advi15 sory Group shall elect a member to serve as chair16 person of the Advisory Group for the life of the Ad17 visory Group. 

18 (2) MEETINGS.—The Advisory Group shall first 

19 meet at the direction of the Secretary. The Advisory 

20 Group shall then meet twice per year and at such 

21 other times as the Advisory Group may provide.

22 (e) TERMINATION.—The Advisory Group shall termi23 nate 30 months after the date of its first meeting. 

24 (f) WAIVER OF ADMINISTRATIVE LIMITATION.—The 

25 Secretary shall establish the Advisory Group notwith-
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1 standing any limitation that may apply to the number of 

2 advisory committees that may be established (within the 

3 Department of Health and Human Services or otherwise).

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