I 
119TH CONGRESS 
1ST SESSION H. R. 3134 
To amend titles XVIII and XIX of the Social Security Act to provide for 
coverage of certain services furnished by freestanding emergency centers. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 1, 2025 
Mr. ARRINGTON (for himself, Mr. VICENTE GONZALEZ of Texas, Mr. CREN-
SHAW, and Ms. VAN DUYNE) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce, and in addition to 
the Committee on Ways and Means, for a period to be subsequently de-
termined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To amend titles XVIII and XIX of the Social Security Act 
to provide for coverage of certain services furnished by 
freestanding emergency centers. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Emergency Care Im-
provement Act’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
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(1) To expand provider capacity to respond to 
the COVID–19 pandemic, in April of 2020 the Cen-
ters for Medicare & Medicaid Services issued a waiv-
er allowing freestanding emergency centers (FECs) 
to enroll as Medicare-certified hospitals and receive 
Medicare reimbursement for the duration of the 
COVID–19 public health emergency. 
(2) FECs are fully licensed emergency depart-
ments that are staffed by both Emergency Medicine 
trained physicians and registered nurses who are on- 
site 24 hours a day, seven days a week, and possess 
licensed pharmacies, clinical laboratories, and ad-
vanced imaging services. FECs are State-licensed, 
and adhere to the same standards and provide the 
same level of care as Hospital Based Emergency 
Rooms, including State EMTALA regulations on 
treating all patients. 
(3) Over 118 FECs, mostly located in Texas, 
have enrolled and provided high-quality emergency 
services for all kinds of emergency conditions at sig-
nificant savings to the Medicare program and to 
thousands of Medicare beneficiaries. 
(4) An actuarial study of Medicare claims data 
found that FECs did not increase overall utilization 
of emergency care services and saved the Medicare 
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program 21.8 percent in lower emergency care pay-
ments for patients of similar acuity. 
SEC. 3. COVERAGE OF FREESTANDING EMERGENCY CEN-
TERS UNDER MEDICARE AND MEDICAID. 
(a) COVERAGE UNDER MEDICARE PART B.—Section 
1832(a)(2) of the Social Security Act (42 U.S.C. 
1395k(a)) is amended— 
(1) in subparagraph (I), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (J), by striking the period 
at the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(K) specified emergency services fur-
nished by a freestanding emergency center (as 
such terms are defined in section 1861(nnn)).’’. 
(b) DEFINITIONS.—Section 1861 of the Social Secu-
rity Act (42 U.S.C. 1395x) is amended by adding at the 
end the following new subsection: 
‘‘(nnn) FREESTANDING EMERGENCY CENTER; SPEC-
IFIED EMERGENCY SERVICES.— 
‘‘(1) FREESTANDING
EMERGENCY
CENTER.— 
The term ‘freestanding emergency center’ means a 
health care facility that— 
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‘‘(A) is an independent freestanding emer-
gency department (as defined in section 
2799A–1(a)(3)(D) of the Public Health Service 
Act); 
‘‘(B) is staffed 24 hours a day, 7 days a 
week, with a physician (as defined in subsection 
(r)(1)) available to furnish emergency services 
(as defined in section 2799A–1(a)(3)(C)(i) of 
the Public Health Service Act) in such facility 
24 hours a day; 
‘‘(C) has arrangements with one or more 
hospitals, having agreements in effect under 
section 1866, for the referral and admission of 
patients requiring inpatient services or such di-
agnostic or other specialized services as are not 
available at such facility; 
‘‘(D) has established a governing body to 
determine, implement, and monitor policies gov-
erning the total operation of the facility; 
‘‘(E) develops, implements, and maintains 
an ongoing, data-driven quality assessment and 
performance improvement program, and has 
oversight and accountability for such program, 
ensuring that facility policies and such program 
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are administered so as to provide quality health 
care in a safe environment; 
‘‘(F) is located— 
‘‘(i) in a metropolitan statistical area; 
or 
‘‘(ii)(I) in the case of a facility estab-
lished prior to 2022, in a rural county; or 
‘‘(II) in the case of a facility estab-
lished on or after January 1, 2022, in a 
rural county that does not have a Medi-
care-certified hospital or a rural emergency 
hospital 
(as 
defined 
in 
subsection 
(kkk)(2)); and 
‘‘(G) meets all State requirements applica-
ble to facilities that furnish emergency medical 
services to individuals but do not typically pro-
vide for stays in excess of 24 hours, and meets 
such other requirements as the Secretary may 
prescribe not in excess of the conditions of par-
ticipation under this title that are applicable to 
off campus dedicated emergency departments of 
hospitals (as described in section 482.55 of title 
42, Code of Federal Regulations (or any suc-
cessor regulation)). 
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