I 
108TH CONGRESS 
1ST SESSION H. R. 2389
To assure that the services of a nonemergency department physician are 
available to hospital patients 24-hours-a-day, seven days a week in all 
non-Federal hospitals with at least 100 licensed beds. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 5, 2003
Mr. VISCLOSKY introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To assure that the services of a nonemergency department 
physician are available to hospital patients 24-hours-a-
day, seven days a week in all non-Federal hospitals with 
at least 100 licensed beds.
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 ‘‘Physician Availability 
Act of 2003’’.
SEC. 2. REQUIREMENT FOR PHYSICIAN AVAILABILITY IN 
ACUTE CARE HOSPITALS. 
(a) IN GENERAL.—Each covered hospital shall have 
a qualified physician available in the hospital 24 hours a 
day, seven days a week to attend to the needs of inpatients 
of the hospital. 
(b) DEFINITIONS.—For purposes of this section: 
(1) COVERED HOSPITAL.—
(A) IN
GENERAL.—Subject to subpara-
graph (B), the term ‘‘covered 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)) that—
(i) has a participation agreement in 
effect under section 1866 of such Act (42 
U.S.C. 1395cc), 
(ii) is participating in the program 
under title XIX of such Act, or 
(iii) is receiving Federal funds under 
a grant or cooperative agreement. 
(B) EXCLUSION FOR FEDERAL FACILITIES 
AND SMALL HOSPITALS.—Such term does not 
include a hospital that—
(i) is a facility of the Federal Govern-
ment, or
(ii) the Secretary of Health and 
Human Services determines has fewer than 
100 licensed beds (as defined by the Sec-
retary). 
(2) PHYSICIAN; QUALIFIED
PHYSICIAN.—(A) 
The term ‘‘physician’’ means, with respect to a hos-
pital, an individual who is a doctor of medicine or 
osteopathy legally authorized under State law to 
practice medicine and surgery in that hospital. 
(B) The term ‘‘qualified physician’’ means, with 
respect to a hospital, an individual who is a physi-
cian and whose credentials as such a physician have 
been verified by the administration of the hospital 
(before providing any services at the hospital) 
through appropriate means, including verification 
through the National Practitioner Databank. 
(3) PHYSICIAN AVAILABILITY.—A physician is 
considered to be ‘‘available’’ in a hospital if—
(A) the physician is physically present in 
the hospital; 
(B) the physician’s primary responsibility 
is to be in attendance to serve the needs of the 
hospital’s inpatients without delay; and 
(C) the physician is not physically present 
in, assigned to, serving in, or expected to cover,
the hospital’s emergency room or emergency de-
partment. 
(c) ENFORCEMENT.—
(1) WARNING.—If the Secretary of Health and 
Human Services (in this section referred to as the 
‘‘Secretary’’) determines that a hospital has violated 
subsection (a), in the first instance the Secretary 
shall provide a written warning regarding such viola-
tion to the hospital and shall notify the Inspector 
General of the Department of Health and Human 
Services (in this section referred to as the ‘‘HHS In-
spector General’’) of such violation. Subsequently, 
the HHS Inspector General shall monitor the com-
pliance of the hospital with the requirement of sub-
section (a). 
(2) SECOND
VIOLATION.—After providing a 
warning to a hospital under paragraph (1), if the 
Secretary determines that the hospital subsequently 
and knowingly violates subsection (a)—
(A) the hospital is subject to a civil money 
penalty in an amount not to exceed $100,000, 
and 
(B) the hospital shall submit to the HHS 
Inspector General, by not later than 30 days 
after the date of such a determination, a reme-
dial plan to prevent future violations of the re-
quirement of such subsection. 
The provisions of section 1128A of the Social Secu-
rity Act (42 U.S.C. 1320a–7a), other than sub-
sections (a) and (b) of such section, shall apply to 
civil money penalties under subparagraph (A) in the 
same manner as they apply to a penalty or pro-
ceeding under subsection (a) of such section. 
(3) SUBSEQUENT VIOLATIONS.—After imposing 
a civil money penalty under paragraph (2) against a 
hospital, if the Secretary determines that the hos-
pital subsequently and knowingly violates subsection 
(a), the Secretary may issue an order disqualifying 
the hospital from participation in the programs 
under titles XVIII and XIX of the Social Security 
Act and from receipt of Federal funds under any 
grant or cooperative agreement for such period as 
the Secretary specifies and until the Secretary re-
ceives satisfactory assurances that the hospital will 
be in substantial compliance with the requirement of 
subsection (a). 
(4) FAILURE TO SUBMIT OR COMPLY WITH RE-
MEDIAL PLAN.—If the Secretary determines, after 
consultation with the HHS Inspector General, that 
a hospital has failed to submit a satisfactory reme-
dial plan required under paragraph (2)(B) or is fail-
ing to substantially carry out such a plan, the Sec-
retary may suspend payment of funds to the hospital 
under titles XVIII and XIX of the Social Security 
Act and under Federal grants or cooperative agree-
ments until the Secretary receives satisfactory assur-
ances that such failures will not continue. 
(d) EFFECTIVE DATE.—This section shall take effect 
on the first day of the first month that begins more than 
180 days after the date of the enactment of this Act.
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