I

106TH CONGRESS

1ST SESSION H. R. 567

To assure that the services of a nonemergency department physician are

available to hospital patients 24-hours-a-day, seven days a week in all

non-Federal hospitals with at least 100 licensed beds.

IN THE HOUSE OF REPRESENTATIVES

FEBRUARY 3, 1999

Mr. VISCLOSKY introduced the following bill; which was referred to the

Committee on Commerce

A BILL

To assure that the services of a nonemergency department

physician are available to hospital patients 24-hours-aday, seven days a week in all non-Federal hospitals with

at least 100 licensed beds.

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 ‘‘Physician Availability

5 Act of 1999’’.
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1 SEC. 2. REQUIREMENT FOR PHYSICIAN AVAILABILITY IN

2 ACUTE CARE HOSPITALS.

3 (a) IN GENERAL.—Each covered hospital shall have

4 a qualified physician available in the hospital 24 hours a

5 day, seven days a week to attend to the needs of inpatients

6 of the hospital.

7 (b) DEFINITIONS.—For purposes of this section:

8 (1) COVERED HOSPITAL.—

9 (A) IN GENERAL.—Subject to subpara10 graph (B), the term ‘‘covered hospital’’ means

11 a subsection (d) hospital (as defined in section

12 1886(d)(1)(B) of the Social Security Act (42

13 U.S.C. 1395ww(d)(1)(B)) that—

14 (i) has a participation agreement in

15 effect under section 1866 of such Act (42

16 U.S.C. 1395cc),

17 (ii) is participating in the program

18 under title XIX of such Act, or

19 (iii) is receiving Federal funds under

20 a grant or cooperative agreement.

21 (B) EXCLUSION FOR FEDERAL FACILITIES

22 AND SMALL HOSPITALS.—Such term does not

23 include a hospital that—

24 (i) is a facility of the Federal Govern25 ment, or
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1 (ii) the Secretary of Health and

2 Human Services determines has fewer than

3 100 licensed beds (as defined by the Sec4 retary).

5 (2) PHYSICIAN; QUALIFIED PHYSICIAN.—(A)

6 The term ‘‘physician’’ means, with respect to a hos7 pital, an individual who is a doctor of medicine or

8 osteopathy legally authorized under State law to

9 practice medicine and surgery in that hospital.

10 (B) The term ‘‘qualified physician’’ means, with

11 respect to a hospital, an individual who is a physi12 cian and whose credentials as such a physician have

13 been verified by the administration of the hospital

14 (before providing any services at the hospital)

15 through appropriate means, including verification

16 through the National Practitioner Databank.

17 (3) PHYSICIAN AVAILABILITY.—A physician is

18 considered to be ‘‘available’’ in a hospital if—

19 (A) the physician is physically present in

20 the hospital;

21 (B) the physician’s primary responsibility

22 is to be in attendance to serve the needs of the

23 hospital’s inpatients without delay; and

24 (C) the physician is not physically present

25 in, assigned to, serving in, or expected to cover,
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1 the hospital’s emergency room or emergency de2 partment.

3 (c) ENFORCEMENT.—

4 (1) WARNING.—If the Secretary of Health and

5 Human Services (in this section referred to as the

6 ‘‘Secretary’’) determines that a hospital has violated

7 subsection (a), in the first instance the Secretary

8 shall provide a written warning regarding such viola9 tion to the hospital and shall notify the Inspector

10 General of the Department of Health and Human

11 Services (in this section referred to as the ‘‘HHS In12 spector General’’) of such violation. Subsequently,

13 the HHS Inspector General shall monitor the com14 pliance of the hospital with the requirement of sub15 section (a).

16 (2) SECOND VIOLATION.—After providing a

17 warning to a hospital under paragraph (1), if the

18 Secretary determines that the hospital subsequently

19 and knowingly violates subsection (a)—

20 (A) the hospital is subject to a civil money

21 penalty in an amount not to exceed $100,000,

22 and

23 (B) the hospital shall submit to the HHS

24 Inspector General, by not later than 30 days

25 after the date of such a determination, a reme-
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1 dial plan to prevent future violations of the re2 quirement of such subsection.

3 The provisions of section 1128A of the Social Secu4 rity Act (42 U.S.C. 1320a–7a), other than sub5 sections (a) and (b) of such section, shall apply to

6 civil money penalties under subparagraph (A) in the

7 same manner as they apply to a penalty or proceed8 ing under subsection (a) of such section.

9 (3) SUBSEQUENT VIOLATIONS.—After imposing

10 a civil money penalty under paragraph (2) against a

11 hospital, if the Secretary determines that the hos12 pital subsequently and knowingly violates subsection

13 (a), the Secretary may issue an order disqualifying

14 the hospital from participation in the programs

15 under titles XVIII and XIX of the Social Security

16 Act and from receipt of Federal funds under any

17 grant or cooperative agreement for such period as

18 the Secretary specifies and until the Secretary re19 ceives satisfactory assurances that the hospital will

20 be in substantial compliance with the requirement of

21 subsection (a).

22 (4) FAILURE TO SUBMIT OR COMPLY WITH RE23 MEDIAL PLAN.—If the Secretary determines, after

24 consultation with the HHS Inspector General, that

25 a hospital has failed to submit a satisfactory reme-
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1 dial plan required under paragraph (2)(B) or is fail2 ing to substantially carry out such a plan, the Sec3 retary may suspend payment of funds to the hospital

4 under titles XVIII and XIX of the Social Security

5 Act and under Federal grants or cooperative agree6 ments until the Secretary receives satisfactory assur7 ances that such failures will not continue.

8 (d) EFFECTIVE DATE.—This section shall take effect

9 on the first day of the first month that begins more than

10 180 days after the date of the enactment of this Act.

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