I 

113TH CONGRESS 

2D SESSION H. R. 5232 

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 HOUSE OF REPRESENTATIVES 

JULY 29, 2014 

Mr. DOGGETT (for himself and Mr. YOUNG of Indiana) introduced the following bill; which was referred to the Committee on Ways and Means, 

and in addition to the Committee on Energy and Commerce, 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 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 (a) IN GENERAL.—Section 1866(a)(1) of the Social 

4 Security Act (42 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) in the case of a hospital, to provide to 

17 each individual who is entitled to benefits under part 

18 A and who the hospital classifies for more than 24 

19 hours as an outpatient under observation status or 

20 any other similar status, as the Secretary determines 

21 appropriate (or to a person acting on the individual’s 

22 behalf), not later than 36 hours after the time of 

23 such classification of such individual under such sta24 tus (or, if sooner, upon discharge), an adequate oral 

25 and written notification (as defined by the Secretary 

26 pursuant to rulemaking and containing such lanVerDate Mar 15 2010 22:17 Jul 30, 2014 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H5232.IH H5232

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1 guage as the Secretary prescribes consistent with 

2 this paragraph) which— 

3 ‘‘(i) explains the status of the individual as 

4 an outpatient under such observation status or 

5 any other such similar status and not as an in6 patient of the hospital; 

7 ‘‘(ii) explains the reason for the classifica8 tion of such individual under such status; 

9 ‘‘(iii) explains the implications of such sta10 tus as an outpatient on— 

11 ‘‘(I) eligibility for coverage of items 

12 and services under this title, including such 

13 items and services furnished by the hos14 pital with respect to such individual while 

15 under such status and for items and serv16 ices under this title for a subsequent dis17 charge to a skilled nursing facility or other 

18 facility; and 

19 ‘‘(II) cost-sharing requirements under 

20 this title, including with respect to items 

21 and services furnished by the hospital to 

22 such individual while under such status 

23 and with respect to items and services 

24 under this title for a subsequent discharge 


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1 to a skilled nursing facility or other facil2 ity; 

3 ‘‘(iv) includes the name and title of the 

4 staff of the hospital who provided the oral noti5 fication and the date and time of such oral noti6 fication; 

7 ‘‘(v) includes such additional information 

8 as the Secretary deems appropriate; and 

9 ‘‘(vi) in the case of the written notification, 

10 is— 

11 ‘‘(I) signed by such individual (or per12 son acting on the individual’s behalf) to ac13 knowledge receipt of such notification; 

14 ‘‘(II) written and formatted using lan15 guage that is clear and easily understand16 able to Medicare beneficiaries; and 

17 ‘‘(III) made available in different lan18 guages, as specified by the Secretary.’’. 

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

20 subsection (a) shall apply with respect to items and serv21 ices furnished on or after the date that is six months after 

22 the date of the enactment of this Act. 

Æ 


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