I 
116TH CONGRESS 
2D SESSION 
H. R. 5727 
To provide for a study by the National Academy of Medicine on ambulance 
diversions, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 30, 2020 
Mr. RUSH (for himself, Mr. THOMPSON of Mississippi, Mrs. WATSON COLE-
MAN, and Ms. BARRAGA´N) introduced the following bill; which was re-
ferred to the Committee on Ways and Means, and in addition to the 
Committee on Energy and Commerce, 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 provide for a study by the National Academy of Medicine 
on ambulance diversions, and for other purposes. 
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 ‘‘Research Empirical 
Solutions to End Ambulance Reversals from Closed Hos-
pitals Act of 2020’’ or the ‘‘RESEARCH Act of 2020’’. 
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SEC. 2. STUDY ON AMBULANCE DIVERSIONS. 
(a) STUDY.—The Secretary of Health and Human 
Services shall seek to enter into an agreement with the 
National Academy of Medicine under which the National 
Academy agrees to conduct a study on ambulance diver-
sions, including— 
(1) whether the number of such diversions have 
increased over the last 10 years, including whether 
the number of such diversions have increased at the 
national, regional, State, and local level; 
(2) what steps, if any, have been taken to re-
duce the number of such diversions; 
(3) whether such diversions disproportionately 
impact medically underserved communities (as de-
fined in section 799B of the Public Health Service 
Act (42 U.S.C. 295p)); and 
(4) what actions the Federal Government 
should take— 
(A) to reduce the number of ambulance di-
versions; and 
(B) to improve the health and safety of pa-
tients affected by ambulance diversions. 
(b) CONSULTATION.—The agreement under sub-
section (a) shall require the study under such agreement 
to be conducted in consultation with— 
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(1) the Assistant Secretary for Planning and 
Evaluation of the Department of Health and Human 
Services; 
(2) the Assistant Secretary for Preparedness 
and Response of the Department of Health and 
Human Services; and 
(3) the Director of the Office of Emergency 
Care Research of the National Institutes of Health. 
(c) REPORT.—The agreement under subsection (a) 
shall provide for— 
(1) the submission to the congressional commit-
tees of jurisdiction, not later than 24 months after 
the date of enactment of this Act, of a report on the 
results of the study under such agreement; and 
(2) the inclusion in such report of recommenda-
tions on actions the Federal Government should 
take— 
(A) to mitigate the occurrence of ambu-
lance diversions; and 
(B) to improve the health and safety of pa-
tients affected by ambulance diversions. 
(d) DEFINITION.—In this section, the term ‘‘ambu-
lance diversion’’ means the temporary closure of a hospital 
emergency department to incoming ambulances. 
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SEC. 3. HOSPITAL REPORTING REQUIREMENT. 
(a) REPORTING REQUIREMENT.—A hospital shall re-
port to the Secretary of Health and Human Services, in 
the case the hospital implements an ambulance diversion 
on or after January 1, 2021— 
(1) how long the diversion was in effect; 
(2) the reason for the diversion; and 
(3) the number of ambulance calls the hospital 
diverted while the diversion was in effect. 
(b) ENFORCEMENT.— 
(1) HOSPITALS.—Section 1886(d)(5) of the So-
cial Security Act (42 U.S.C. 1395ww(d)(5)) is 
amended by adding at the end the following new 
subparagraph: 
‘‘(M)(i)(I) In the case that the Secretary determines, 
with respect to a calendar quarter occurring in the period 
beginning with 2021 and ending with 2024, that a hospital 
has complied with the provisions of section 3(a) of the RE-
SEARCH Act of 2020 with respect to each ambulance di-
version (if any) that occurred during such quarter, the 
Secretary shall increase, by the percentage specified in 
subclause (II) for such quarter, the amount otherwise pay-
able to such hospital under paragraph (1)(A) for dis-
charges occurring in the succeeding quarter. 
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‘‘(II) For purposes of subclause (I), the percentage 
specified in this subclause is, with respect to a calendar 
quarter occurring in— 
‘‘(aa) 2021 or 2022, 1 percent; or 
‘‘(bb) 2023 or 2024, 0.5 percent. 
‘‘(ii)(I) In the case that the Secretary determines, 
with respect to a calendar quarter occurring in 2025 or 
a subsequent year, that a hospital has failed to report an 
ambulance diversion occurring during such quarter to the 
Secretary in accordance with section 3(a) of the RE-
SEARCH Act of 2020, the Secretary shall reduce, by the 
percentage specified in subclause (II) for such quarter, the 
amount otherwise payable to such hospital under para-
graph (1)(A) for discharges occurring in the succeeding 
quarter. 
‘‘(II) For purposes of subclause (I), the percentage 
specified in this subclause is, with respect to a calendar 
quarter occurring in— 
‘‘(aa) 2025, 1 percent; or 
‘‘(bb) 2026 or a subsequent year, 2 percent. 
‘‘(iii) In this subparagraph, the term ‘ambulance di-
version’ has the meaning given such term in section 2 of 
the RESEARCH Act of 2020.’’. 
(2) CRITICAL
ACCESS
HOSPITALS.—Section 
1814(l) of the Social Security Act (42 U.S.C. 
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1395f(l)) is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(6)(A)(i) In the case that the Secretary determines, 
with respect to a calendar quarter occurring in the period 
beginning with 2021 and ending with 2024, that a critical 
access hospital has complied with the provisions of section 
3(a) of the RESEARCH Act of 2020 with respect to each 
ambulance diversion (if any) that occurred during such 
quarter, the Secretary shall increase, by the percentage 
specified in clause (ii) for such quarter, the amount other-
wise payable to such hospital under paragraph (1) for 
services furnished during the succeeding quarter. 
‘‘(ii) For purposes of clause (i), the percentage speci-
fied in this clause is, with respect to a calendar quarter 
occurring in— 
‘‘(I) 2021 or 2022, 1 percent; or 
‘‘(II) 2023 or 2024, 0.5 percent. 
‘‘(B)(i) In the case that the Secretary determines, 
with respect to a calendar quarter occurring in 2025 or 
a subsequent year, that a critical access hospital has failed 
to report an ambulance diversion occurring during such 
quarter to the Secretary in accordance with section 3(a) 
of the RESEARCH Act of 2020, the Secretary shall re-
duce, by the percentage specified in clause (ii) for such 
quarter, the amount otherwise payable to such hospital 
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under paragraph (1) for services furnished during the suc-
ceeding quarter. 
‘‘(ii) For purposes of clause (i), the percentage speci-
fied in this clause is, with respect to a calendar quarter 
occurring in— 
‘‘(I) 2025, 1 percent; or 
‘‘(II) 2026 or a subsequent year, 2 percent.’’. 
(c) DEFINITION.—In this section: 
(1) The term ‘‘ambulance diversion’’ has the 
meaning given to such term in section 2. 
(2) The term ‘‘hospital’’ means a subsection (d) 
hospital (as defined in section 1886(d)(1)(B) of the 
Social Security Act (42 U.S.C. 1395ww(d)(1)(B))), 
or a critical access hospital (as defined in section 
1861(mm) of such Act (42 U.S.C. 1395x(mm))), en-
rolled under section 1866(j) of such Act (42 U.S.C. 
1392cc(j)). 
Æ 
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