SEC. 2. COVERAGE OF AMBULANCE SERVICES TO QUALI-
FIED OUTPATIENT FACILITIES.
(a) IN GENERAL.—Section 1861(e) of the Social Se-
curity Act (42 U.S.C. 1395x(e)) is amended by adding at
the end the following: ‘‘For purposes of subsection (s)(7),
such term also includes a qualified outpatient facility (as
defined in subsection (uu)).’’.
(b) DEFINITION OF QUALIFIED OUTPATIENT FACIL-
ITY.—Section 1861 of the Social Security Act (42 U.S.C.
1395x) is amended by adding at the end the following new
subsection:
‘‘Qualified Outpatient Facility
‘‘(uu) The term ‘qualified outpatient facility’ means
an outpatient facility located in a rural area (as defined
in 1886(d)(2)(D)) that meets the following requirements:
‘‘(1) SERVICES FURNISHED.—The facility fur-
nishes some of the outpatient services furnished by
a hospital, such as emergency services, diagnostic
imaging, ambulatory surgery, catheterization lab,
physicians’ services, wellness centers and health edu-
cation libraries, urgent care, birthing services, lab-
oratory, and other essential support services (includ-
ing information and communication systems).
‘‘(2) LIMITATION ON LENGTH OF STAY.—The
length of stay permitted in the facility is less than
24 hours.
‘‘(3) EMERGENCY
ROOM
COVERAGE.—During
the operating hours of the facility, the facility makes
available emergency care services that are necessary
for ensuring access to such services in the rural
area.
‘‘(4) TRANSFER
AGREEMENTS.—The facility
has an agreement with a hospital with respect to
each of the following:
‘‘(A) Patient referral and transfer.
‘‘(B) The provision of emergency and non-
emergency transportation between the facility
and the hospital.
‘‘(C) Communications systems for sharing
patient data.
‘‘(5) PROTOCOLS WITH PROVIDERS OF AMBU-
LANCES SERVICES.—The facility has established pro-
tocols with providers of ambulance services to ensure
that the transportation of individuals to the facility
is limited to individuals with medical conditions that
are suitable for treatment in the facility in accord-
ance with a State medical control plan, or in the ab-
sence of such a plan, in accordance with medical
control guidelines established by the Secretary.
‘‘(6) DESIGNATED
NECESSARY
RURAL
PRO-
VIDER.—The facility is located in one of the fol-
lowing areas:
‘‘(A) An area designated (under section
332(a)(1)(A) of the Public Health Service Act)
as a health professional shortage area.
‘‘(B) A rural area designated by the Sec-
retary as medically underserved under section
330(b)(3) of the Public Health Service Act.
‘‘(C) A county in a State which has an un-
employment rate greater than the statewide av-
erage unemployment rate.
‘‘(D) A county in a State in which the per-
centage of residents aged 65 and older is great-
er than the statewide average percentage for
such residents.
‘‘(E) A county in a State in which the per-
centage of families with incomes below 200 per-
cent of the income official poverty line (as de-
fined by the Office of Management and Budget,
and revised annually in accordance with section
673(2) of the Omnibus Budget Reconciliation
Act of 1981) applicable to a family of the size
involved is higher than the statewide average
for such families with such incomes.’’.
(c) EFFECTIVE DATE.—The amendment made by
subsection (a) applies with respect to ambulance services
furnished on or after the date of the enactment of this
Act.
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