I 

111TH CONGRESS 

1ST SESSION H. R. 1678 

To amend the Internal Revenue Code of 1986 to allow a bad debt deduction 

to doctors to partially offset the cost of providing uncompensated care 

required to be provided under amendments made by the Emergency 

Medical Treatment and Labor Act. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 24, 2009 

Mrs. BONO MACK introduced the following bill; which was referred to the 

Committee on Ways and Means 

A BILL 

To amend the Internal Revenue Code of 1986 to allow a 

bad debt deduction to doctors to partially offset the 

cost of providing uncompensated care required to be 

provided under amendments made by the Emergency 

Medical Treatment and Labor Act. 

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 ‘‘Mitigating the Impact 

5 of Uncompensated Service and Time Act of 2009’’. 


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1 SEC. 2. BAD DEBT DEDUCTION FOR DOCTORS TO PAR2 TIALLY OFFSET THE COST OF PROVIDING UN3 COMPENSATED CARE REQUIRED TO BE PRO4 VIDED UNDER AMENDMENTS MADE BY THE 

5 EMERGENCY MEDICAL TREATMENT AND 

6 LABOR ACT. 

7 (a) IN GENERAL.—Section 166 of the Internal Rev8 enue Code of 1986 (relating to bad debts) is amended by 

9 redesignating subsection (f) as subsection (g) and by in10 serting after subsection (e) the following new subsection: 

11 ‘‘(f) BAD DEBT TREATMENT FOR DOCTORS TO PAR12 TIALLY OFFSET COST OF PROVIDING UNCOMPENSATED

13 CARE REQUIRED TO BE PROVIDED.— 

14 ‘‘(1) AMOUNT OF DEDUCTION.— 

15 ‘‘(A) IN GENERAL.—For purposes of sub16 section (a), the basis for determining the 

17 amount of any deduction for an eligible 

18 EMTALA debt shall be treated as being equal 

19 to the excess of— 

20 ‘‘(i) the Medicare payment amount, 

21 over 

22 ‘‘(ii) any other compensation received 

23 with respect to such debt. 

24 ‘‘(B) MEDICARE PAYMENT AMOUNT.—For 

25 purposes of subparagraph (A), the Medicare 

26 payment amount with respect to an eligible 


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1 EMTALA debt is the fee schedule amount es2 tablished under section 1848 of the Social Secu3 rity Act for the physicians’ service (to which 

4 such debt relates) as if the service were pro5 vided to an individual enrolled under part B of 

6 title XVIII of such Act. 

7 ‘‘(2) ELIGIBLE EMTALA DEBT.—For purposes 

8 of this section, the term ‘eligible EMTALA debt’ 

9 means any debt if— 

10 ‘‘(A) such debt arose as a result of physi11 cians’ services— 

12 ‘‘(i) which were performed in an 

13 EMTALA hospital by a physician (whether 

14 as part of medical screening or necessary 

15 stabilizing treatment and whether as an 

16 emergency department physician, as an on17 call physician, or otherwise), and 

18 ‘‘(ii) which were required to be pro19 vided under section 1867 of the Social Se20 curity Act (42 U.S.C. 1395dd), and 

21 ‘‘(B) such debt is owed— 

22 ‘‘(i) to such physician, or 

23 ‘‘(ii) to an entity if— 


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1 ‘‘(I) such entity is a corporation 

2 and the sole shareholder of such cor3 poration is such physician, or 

4 ‘‘(II) such entity is a partnership 

5 and any deduction under this sub6 section with respect to such debt is al7 located to such physician or to an en8 tity described in subclause (I). 

9 ‘‘(3) OTHER DEFINITIONS.—For purposes of 

10 this subsection— 

11 ‘‘(A) EMERGENCY DEPARTMENT PHYSI12 CIAN.—The term ‘emergency department physi13 cian’ means any physician who is recognized as 

14 a career emergency physician, as evidenced by 

15 membership in the American College of Emer16 gency Physicians, or is certified by the Amer17 ican Board of Emergency Medicine, the Amer18 ican Osteopathic Board of Emergency Medicine, 

19 or the American Board of Pediatrics. 

20 ‘‘(B) PHYSICIAN.—The term ‘physician’ 

21 has the meaning given such term in section 

22 1861(r) of the Social Security Act (42 U.S.C. 

23 1395x(r)). 

24 ‘‘(C) EMTALA HOSPITAL.—The term 

25 ‘EMTALA hospital’ means any hospital having 


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1 a hospital emergency department which is re2 quired to comply with section 1867 of the So3 cial Security Act (42 U.S.C. 1395dd) (relating 

4 to examination and treatment for emergency 

5 medical conditions and women in labor). 

6 ‘‘(D) PHYSICIANS’ SERVICES.—The term 

7 ‘physicians’ services’ has the meaning given 

8 such term in section 1861(q) of the Social Se9 curity Act (42 U.S.C. 1395x(q)).’’. 

10 (b) EFFECTIVE DATE.—The amendments made by 

11 this section shall apply to debts arising from services per12 formed in taxable years beginning after the date of the 

13 enactment of this Act. 

Æ 


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