II 

114TH CONGRESS 

1ST SESSION S. 1349 

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. 

IN THE SENATE OF THE UNITED STATES 

MAY 14, 2015 

Mr. CARDIN (for himself and Mr. ENZI) introduced the following bill; which 

was read twice and referred to the Committee on Finance 

A BILL 

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, 

3 SECTION 1. SHORT TITLE. 

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

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

6 ‘‘NOTICE Act’’. 


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1 SEC. 2. MEDICARE REQUIREMENT FOR HOSPITAL NOTIFI2 CATIONS OF OBSERVATION STATUS. 

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

4 U.S.C. 1395cc(a)(1)) is amended— 

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

6 ‘‘and’’; 

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

8 at the end the period and inserting a comma; 

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

10 (A) by redesignating such subparagraph as 

11 subparagraph (X); and 

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

13 inserting ‘‘, and’’; and 

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

15 the following new subparagraph: 

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

17 enactment of this subparagraph, in the case of a 

18 hospital or critical access hospital, with respect to 

19 each individual who receives observation services as 

20 an outpatient at such hospital or critical access hos21 pital for more than 24 hours, to provide to such in22 dividual not later than 36 hours after the time such 

23 individual begins receiving such services (or, if soon24 er, upon release)— 

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

26 notification described in clause (ii), and such 


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1 documentation of the provision of such expla2 nation, as the Secretary determines to be ap3 propriate; 

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

5 the Secretary pursuant to rulemaking and con6 taining such language as the Secretary pre7 scribes consistent with this paragraph) which— 

8 ‘‘(I) explains the status of the indi9 vidual as an outpatient receiving observa10 tion services and not as an inpatient of the 

11 hospital or critical access hospital and the 

12 reasons for such status of such individual; 

13 ‘‘(II) explains the implications of such 

14 status on services furnished by the hospital 

15 or critical access hospital (including serv16 ices furnished on an inpatient basis), such 

17 as implications for cost-sharing require18 ments under this title and for subsequent 

19 eligibility for coverage under this title for 

20 services furnished by a skilled nursing fa21 cility; 

22 ‘‘(III) includes such additional infor23 mation as the Secretary determines appro24 priate; 

25 ‘‘(IV) either— 


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1 ‘‘(aa) is signed by such individual 

2 or a person acting on such individ3 ual’s behalf to acknowledge receipt of 

4 such notification; or 

5 ‘‘(bb) if such individual or person 

6 refuses to provide the signature de7 scribed in item (aa), is signed by the 

8 staff member of the hospital or crit9 ical access hospital who presented the 

10 written notification and includes the 

11 name and title of such staff member, 

12 a certification that the notification 

13 was presented, and the date and time 

14 the notification was presented; and 

15 ‘‘(V) is written and formatted using 

16 plain language and is made available in ap17 propriate languages as determined by the 

18 Secretary.’’. 

Æ 


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