IB 
Union Calendar No. 25 
114TH CONGRESS 
1ST SESSION 
H. R. 876 
[Report No. 114–39, Part I] 
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 
FEBRUARY 11, 2015 
Mr. DOGGETT (for himself and Mr. YOUNG of Indiana) introduced the fol-
lowing 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 consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
MARCH 13, 2015 
Additional sponsors: Mr. BLUMENAUER and Mr. RANGEL 
MARCH 13, 2015 
Reported from the Committee on Ways and Means with an amendment 
[Strike out all after the enacting clause and insert the part printed in italic] 
MARCH 13, 2015 
The Committee on Energy and Commerce discharged; committed to the Com-
mittee of the Whole House on the State of the Union and ordered to be 
printed 
[For text of introduced bill, see copy of bill as introduced on February 11, 2015] 
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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. 
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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 ‘‘Notice of Observation 
Treatment and Implication for Care Eligibility Act’’ or the 
‘‘NOTICE Act’’. 
SEC. 2. MEDICARE REQUIREMENT FOR HOSPITAL NOTIFI-
CATIONS OF OBSERVATION STATUS. 
Section 1866(a)(1) of the Social Security Act (42 
U.S.C. 1395cc(a)(1)) is amended— 
(1) in subparagraph (V), by striking at the end 
‘‘and’’; 
(2) in the first subparagraph (W), by striking at 
the end the period and inserting a comma; 
(3) in the second subparagraph (W)— 
(A) by redesignating such subparagraph as 
subparagraph (X); and 
(B) by striking at the end the period and 
inserting ‘‘, and’’; and 
(4) by inserting after such subparagraph (X) the 
following new subparagraph: 
‘‘(Y) beginning 12 months after the date of the 
enactment of this subparagraph, in the case of a hos-
pital or critical access hospital, with respect to each 
individual who receives observation services as an 
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outpatient at such hospital or critical access hospital 
for more than 24 hours, to provide to such individual 
not later than 36 hours after the time such individual 
begins receiving such services (or, if sooner, upon re-
lease)— 
‘‘(i) such oral explanation of the written no-
tification described in clause (ii), and such docu-
mentation of the provision of such explanation, 
as the Secretary determines to be appropriate; 
‘‘(ii) a written notification (as specified by 
the Secretary pursuant to rulemaking and con-
taining such language as the Secretary prescribes 
consistent with this paragraph) which— 
‘‘(I) explains the status of the indi-
vidual as an outpatient receiving observa-
tion services and not as an inpatient of the 
hospital or critical access hospital and the 
reasons for such status of such individual; 
‘‘(II) explains the implications of such 
status on services furnished by the hospital 
or critical access hospital (including serv-
ices furnished on an inpatient basis), such 
as implications for cost-sharing require-
ments under this title and for subsequent 
eligibility for coverage under this title for 
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services furnished by a skilled nursing facil-
ity; 
‘‘(III) includes such additional infor-
mation as the Secretary determines appro-
priate; 
‘‘(IV) either— 
‘‘(aa) is signed by such individual 
or a person acting on such individual’s 
behalf to acknowledge receipt of such 
notification; or 
‘‘(bb) if such individual or person 
refuses to provide the signature de-
scribed in item (aa), is signed by the 
staff member of the hospital or critical 
access hospital who presented the writ-
ten notification and includes the name 
and title of such staff member, a cer-
tification that the notification was pre-
sented, and the date and time the noti-
fication was presented; and 
‘‘(V) is written and formatted using 
plain language and is made available in 
appropriate languages as determined by the 
Secretary.’’. 
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Union Calendar No. 25 
114TH CONGRESS 
1ST SESSION 
H. R. 876 
[Report No. 114–39, Part I] 
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 inpa-
tients of such hospitals. 
MARCH 13, 2015 
Reported from the Committee on Ways and Means with 
an amendment 
MARCH 13, 2015 
The Committee on Energy and Commerce discharged; 
committed to the Committee of the Whole House on 
the State of the Union and ordered to be printed 
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