114TH CONGRESS 

1ST SESSION H. R. 876 

AN ACT 

To amend title XVIII of the Social Security Act to require 

hospitals to provide certain notifications to individuals 

classified by such hospitals under observation status 

rather than admitted as inpatients of such hospitals. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 
2 

•HR 876 EH

1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Notice of Observation 

3 Treatment and Implication for Care Eligibility Act’’ or the 

4 ‘‘NOTICE Act’’. 

5 SEC. 2. MEDICARE REQUIREMENT FOR HOSPITAL NOTIFI6 CATIONS OF OBSERVATION STATUS. 

7 Section 1866(a)(1) of the Social Security Act (42 

8 U.S.C. 1395cc(a)(1)) is amended— 

9 (1) in subparagraph (V), by striking at the end 

10 ‘‘and’’; 

11 (2) in the first subparagraph (W), by striking 

12 at the end the period and inserting a comma; 

13 (3) in the second subparagraph (W)— 

14 (A) by redesignating such subparagraph as 

15 subparagraph (X); and 

16 (B) by striking at the end the period and 

17 inserting ‘‘, and’’; and 

18 (4) by inserting after such subparagraph (X) 

19 the following new subparagraph: 

20 ‘‘(Y) beginning 12 months after the date of the 

21 enactment of this subparagraph, in the case of a 

22 hospital or critical access hospital, with respect to 

23 each individual who receives observation services as 

24 an outpatient at such hospital or critical access hos25 pital for more than 24 hours, to provide to such in26 dividual not later than 36 hours after the time such 
3 

•HR 876 EH

1 individual begins receiving such services (or, if soon2 er, upon release)— 

3 ‘‘(i) such oral explanation of the written 

4 notification described in clause (ii), and such 

5 documentation of the provision of such expla6 nation, as the Secretary determines to be ap7 propriate; 

8 ‘‘(ii) a written notification (as specified by 

9 the Secretary pursuant to rulemaking and con10 taining such language as the Secretary pre11 scribes consistent with this paragraph) which— 

12 ‘‘(I) explains the status of the indi13 vidual as an outpatient receiving observa14 tion services and not as an inpatient of the 

15 hospital or critical access hospital and the 

16 reasons for such status of such individual; 

17 ‘‘(II) explains the implications of such 

18 status on services furnished by the hospital 

19 or critical access hospital (including serv20 ices furnished on an inpatient basis), such 

21 as implications for cost-sharing require22 ments under this title and for subsequent 

23 eligibility for coverage under this title for 

24 services furnished by a skilled nursing fa25 cility; 
4 

•HR 876 EH

1 ‘‘(III) includes such additional infor2 mation as the Secretary determines appro3 priate; 

4 ‘‘(IV) either— 

5 ‘‘(aa) is signed by such individual 

6 or a person acting on such individ7 ual’s behalf to acknowledge receipt of 

8 such notification; or 

9 ‘‘(bb) if such individual or person 

10 refuses to provide the signature de11 scribed in item (aa), is signed by the 

12 staff member of the hospital or crit13 ical access hospital who presented the 

14 written notification and includes the 

15 name and title of such staff member, 

16 a certification that the notification 

17 was presented, and the date and time 

18 the notification was presented; and 

19 ‘‘(V) is written and formatted using 

20 plain language and is made available in ap-
5 

•HR 876 EH

1 propriate languages as determined by the 

2 Secretary.’’. 

Passed the House of Representatives March 16, 

2015. 

Attest: 

Clerk. 
114TH CONGRESS 

1ST SESSION H. R. 876 

AN ACT 

To amend title XVIII of the Social Security Act to 

tients of such hospitals. observation status rather than admitted as inpato individuals classified by such hospitals under require hospitals to provide certain notifications